2025 KFF Marketplace Enrollees Survey
In 2025, 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.
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In 2025, 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.
Adults ages 50 to 64 are disproportionately affected by the expiration of ACA enhanced premium tax credits because they make up a large number of Marketplace enrollees and premiums rise with age.
Following the expiration of the enhanced premium tax credits for people with Affordable Care Act (ACA) Marketplace plans, a new KFF follow-up survey of the same Marketplace enrollees KFF surveyed in 2025 finds half (51%) of returning enrollees say their health care costs are “a lot higher” this year compared to last year, including four in 10 who specifically say their premiums are “a lot higher.”
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A number of options may be available to you: If your annual income is $21,597 or less in 2026 (138% federal poverty level for a single adult), you may qualify for Medicaid coverage. Not all states have elected to expand Medicaid eligibility to this income level.
If, for any reason, you cannot obtain this information from your employer, you should report to the Marketplace what you know, yourself, about your eligibility for employer-sponsored coverage, the cost of that coverage, and whether it meets minimum value standards.
Scholarship and fellowship payments for tuition and fees and course-related expenses required of all students are not counted as income in determining your eligibility for premium tax credits. Scholarship payments for room and board are included in determining your eligibility.
Federal tax rules set out what is included in your household income. Eligibility for and the amount of premium tax credits are largely based on your household income.
You can only drop COBRA and sign up for a Marketplace plan and premium tax credits during Open Enrollment. You will have to drop your COBRA coverage effective the date your new Marketplace plan coverage begins.
Yes. Although the general rule is that people are not eligible for Marketplace subsidies when they are also eligible for affordable job-based health coverage, a young adult is eligible for premium tax credits in the Marketplace as long as they are not claimed as a tax dependent by their parents.
While employers with 50 or more workers who do not offer health benefits to full-time workers and their dependent children could be subject to a penalty, there is no requirement for employers to offer health benefits to the spouses of full-time workers.
Start by applying for coverage online at HealthCare.gov, via paper application by mail, or by contacting the Marketplace call center and applying over the phone. Applying online is likely the fastest of these options. To apply online, you will need to create a secure personal account with a login ID and password.
That’s up to you.
Yes. Many insurers that offer plans through the ACA Marketplace also offer identical plans outside of the Marketplace that meet all ACA standards, although premium tax credits and cost-sharing subsidies are not available for plans sold outside of the Marketplace.
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