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The ACA Marketplace

2025 KFF Marketplace Enrollees Survey

About one in three ACA enrollees said they would be “very likely” to look for a lower-premium Marketplace plan If their premium payments doubled, according to a KFF survey conducted in 2025.

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Tracking the Public’s Views on the ACA

While overall opinion of the Affordable Care Act has been more favorable than unfavorable since 2017, there remain deep partisan divides. See how public opinion on the ACA has changed from the inception of the law to the present. This interactive tool highlights key moments when views shifted and trends based on party identification, income, age, gender, and race/ethnicity.

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  • KFF September Tracking Poll Looks at Health Reform and the Elections

    Perspective

    The tug of war for public opinion on health reform continues this month, with approval and disapproval remaining in the same relatively narrow band each has occupied since passage even as favorable views regain a small upper hand, 49 percent favorable vs. 40 percent unfavorable. Opinion is more closely divided among this fall’s likely voters (46 percent vs. 45 percent), and opponents of the law continue to hold their views more emphatically than supporters. Meanwhile,…

  • Dissatisfaction with Health Insurance Despite Positive Ratings

    Perspective

    Personal experiences with the health care system are a key factor in Americans’ opinions on how the health care system should function and their expectations of how the Affordable Care Act (ACA) will change the system when fully implemented. In order to take a closer look at these personal experiences, this post explores findings from the March Kaiser Health Tracking Poll on Americans’ views of their health care and coverage, including health insurance ratings and…

  • Kaiser November Health Tracking Poll: Individual Elements of the ACA Popular with the Public

    Perspective

    After taking a negative turn in October, the public’s overall views on the Patient Protection and Affordable Care Act (ACA) returned to a more mixed status this month. Still, Americans remain somewhat more likely to have an unfavorable view of the law (44 percent) than a favorable one (37 percent). The Kaiser Family Foundation's November Health Tracking Poll also finds that individual elements of the law are viewed favorably by a majority of the public. The law’s…

  • July Kaiser Health Tracking Poll: Public Still Divided on ACA, Few Believe the Law Will Improve Consumer Protections

    Perspective

    Overall public opinion on the health reform law remains unchanged this month, with 42 percent of Americans holding a favorable view and 43 percent an unfavorable view. Even though previous Health Tracking polls have consistently shown that consumer protections were one of the least controversial and most widely supported provisions of the health reform law, the July poll finds that just one in five Americans think the law will lead to improvements in consumer protections…

  • December Kaiser Health Tracking Poll: Public Again Divided on ACA, Independents Polarized, and Exchanges Widely Popular

    Perspective

    According to the December Kaiser Health Tracking Poll, the October downturn in the share of Americans with a favorable view of the health reform law has been fully reversed in December and overall opinion on the law returned to the roughly even split seen for most of 2011. Forty-three percent of Americans expressed unfavorable views of the law in December, while 41 percent had favorable views. Partisan divisions persist and the findings suggest not only…

  • Peering Into the Black Box of Insurance Rating

    Perspective

    Recently, the New York Times reported that private health insurers continue to seek large premium increases despite seeing lower than expected use of medical care and booking record profits. The story highlights a significant problem for health policy: the lack of good, public information about how health insurers manage health care use and what they pay for medical services. As a nation, we rely on competition among largely private health plans to ensure that health…

  • June Kaiser Health Tracking Poll: Americans Still Divided on Health Reform Law

    Perspective

    In the latest Kaiser Health Tracking Poll, the public remains divided in their overall assessments of the ACA, with 42 percent holding a favorable view of the law and 46 percent an unfavorable one. This month’s poll finds Americans are somewhat more likely to think their own families, seniors as a group, and the Medicare program will be worse off rather than better off under the law, though large shares say they don’t know or…

  • September Kaiser Health Tracking Poll: Pre-Existing Conditions

    Perspective

    With several elements of the ACA targeted toward individuals with pre-existing conditions, this month’s Kaiser Health Tracking Poll takes a closer look at this group. Fifty-two percent of Americans say that they or someone else in their household has what would be considered a “pre-existing condition,” and among this group, one in five (21 percent) say they or their family member has had difficulty getting health insurance because of this condition. Yet many of these people…

  • Increasing Medicaid Payments for Certain Primary Care Physicians in 2013 and 2014: A Primer on the Health Reform Provision and Final Rule

    Issue Brief

    To help ensure that access in Medicaid expands to meet anticipated higher demand for care, the health reform law requires states to pay certain physicians Medicaid fees that are at least equal to Medicare’s for a list of 146 primary care services in 2013 and 2014. The idea is to attract new physicians to Medicaid and provide greater support for physicians who already participate. As a result, Medicaid fees paid to certain physicians for primary…

  • Health Insurance Market Reforms: Rate Review

    Fact Sheet

    Rate review is the process by which insurance regulators review health plans’ new or renewed rates for insurance policies in order to ensure that the rates charged are based on accurate, verifiable data and realistic projections of health costs. Historically, state insurance departments have conducted rate review, but under the Affordable Care Act (ACA), federal regulators may review rate increases in some cases. This fact sheet explains how rate review works and how the ACA…