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Affordable Care Act

Enhanced Premium tax credits

2025 KFF Marketplace Enrollees Survey

If their premium payments double, about one in three ACA enrollees say they would be “very likely” to look for a lower-premium Marketplace plan.

Updated Larry QT on ePTCs

There is No Drop-Dead Date for an ACA Tax Credit Extension, But Coverage Losses Will Mount as the Clock Ticks

A discharge petition in the House paves the way for a vote on a three-year extension of the tax credits, which would provide ACA enrollees premium relief whenever it comes. While there is still time to extend the enhanced tax credits, with each passing day, more and more ACA Marketplace enrollees are going to drop their health insurance when faced with eye-popping increases in their premium payments, writes KFF’s Larry Levitt.

ACA Marketplaces

Affordable Care Act Signups Are Down, But Still an Incomplete Picture

Data from CMS may not fully show how much the expiration of the enhanced premium tax credits has affected enrollment in the ACA Marketplaces. The extent of enrollment changes likely won’t be known until this summer, when effectuated enrollment data are typically released.
DATA

Marketplace Enrollment Snapshot for Open Enrollment 2026

ANALYSIS

Higher Premium Payments or Higher Deductibles: The ACA's Tradeoffs

DATA

Number of Insurers in the Individual Insurance Marketplaces

ANALYSIS

Competition Increased in Individual Market But Fell in Fully Insured Group Markets

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  • Corporate Leaders Are Getting Bullish On Government Action On Health Care Costs

    From Drew Altman

    In this Axios column, Drew Altman explores whether the long struggle with rising health costs has caused the tide to turn in corporate leaders’ attitudes towards government involvement in controlling health spending and whether it is part of a larger shift in comfort with government action to solve problems.

  • Filling the Coverage Gap: Policy Options and Considerations

    Issue Brief

    This issue brief examines some of the other options policymakers may consider to extend coverage to people in the gap, including increased fiscal incentives for states, a narrower public option, and making people with incomes below the poverty level eligible for enhanced ACA premium subsidies.

  • Health Spending for 60-64 Year Olds Would Be Lower Under Medicare Than Under Large Employer Plans

    Issue Brief

    During the presidential campaign, President Biden proposed to lower the age of Medicare eligibility from 65 to 60. This analysis uses claims data for covered medical services from both large employer plans and traditional Medicare to illustrate the potential spending effects of using Medicare payment rates in lieu of higher rates paid by employer plans for people 60-64 who shift from large employer plans to Medicare.

  • The ACA Family Glitch and Affordability of Employer Coverage

    Issue Brief

    This analysis estimates that 5.1 million people fall into the Affordable Care Act's "family glitch," which occurs when a worker receives an offer of affordable employer coverage for themselves but not for their dependents, making them ineligible for financial assistance for marketplace coverage. It explores the demographic characteristics of this group, including state-level estimates.

  • Sources of Payment for Uncompensated Care for the Uninsured

    Issue Brief

    This brief estimates the level of public funding that was paid to help offset providers’ uncompensated care costs for the uninsured in 2017. To conduct the analysis, we rely on several secondary data sources including government budget appropriations and expenditure data for major public programs that provided funds to cover the cost of care for the uninsured, as well as analyses of secondary data sources completed by others.

  • Declines in Uncompensated Care Costs for The Uninsured under the ACA and Implications of Recent Growth in the Uninsured Rate

    Issue Brief

    The increase in the uninsured rate in recent years, as well as loss of coverage during the pandemic, has led to attention on the consequences of being uninsured. The need for medical care to test, treat, or prevent COVID-19 has also highlighted the potential consequences of uncompensated care for uninsured people. Uncompensated care costs occur because, although people who are uninsured use less care than people with coverage, most who are uninsured have limited income or resources and cannot afford the high cost of medical care, if and when they do need or use health care.