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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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. Check with a tax advisor, but in general, for divorce or separation agreements after December 31, 2018, alimony payments are no longer deductible from the income of the paying ex-spouse, and alimony is not included as income for the recipient ex-spouse. For pre-2019 divorces, the paying ex-spouse…
Eligibility for premium tax credits is based on your Modified Adjusted Gross Income, or MAGI. Click here for a list of the types of income that qualifies as MAGI.
Premium tax credits are available to people who buy Marketplace coverage and whose income is at least as high as the federal poverty level. For an individual, that means an income of at least $15,650 in 2026. For a family of four, that means an income of at least $32,150 in 2026. This Marketplace subsidy calculator can show you your eligibility for different income amounts and family sizes.
Yes, you can. Since your employer pays 100% of the premium to cover you, you will not be eligible for premium tax credits, but your spouse and children may be eligible for financial assistance on the Marketplace, depending on the affordability of your employer’s family coverage. If the premium contribution you would have to pay to cover your spouse and kids under your employer plan is more than 9.96% of your household income in 2026,…
In general, if you have or are offered other comprehensive, affordable coverage, you may not be eligible for premium tax credits on the Marketplace. However, there are several circumstances where you may be eligible. This chart lays out examples of different coverage types and whether or not they will disqualify you for premium tax credits.
Yes, you can apply for premium tax credits this year. One challenge you may encounter is verifying your income. The Marketplace verifies an applicant's estimated income in real time during the application process, using IRS data from recent federal income tax returns, and sometimes other data sources. However, since you have never filed a tax return, the Marketplace must accept your self-attestation of projected annual income.
If this is your first time applying for premium tax credits, then yes. There is no requirement to have filed a tax return for any prior year to qualify for premium tax credits. However, because you have never filed a federal tax return, you will likely have to provide additional documentation (such as pay stubs or a work contract) to the Marketplace within 90 days to verify your projected household income for premium tax credits. …
Assuming you are part of one application, the members of your household can enroll in separate plans in a health insurance Marketplace. For example, you may want separate plans because a grown child lives in another part of the state or because your spouse needs a plan with a different provider network than the one you chose. The premium tax credit will be allocated to the plans in which different family members enroll. However, if…
That’s up to you. You can have tax credits paid directly to your health plan each month to reduce your monthly premium right away, or, if you can afford to, you can pay the entire health plan premium yourself up front and collect the premium tax credit in a lump sum next year when you file your tax return. Alternatively, you can have some of the tax credit paid directly to your insurer in advance…
Premium tax credits reduce your premium for most Marketplace plans. The amount of the tax credit you may receive depends on your income and the cost of Marketplace health plans in your area. The Marketplace will determine the expected contribution you are required to pay toward the premium for a mid-range (Silver) benchmark plan. The expected contribution will increase on a sliding scale based on your 2026 income, with more financial assistance for enrollees with…
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