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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

QUIZ

Test Your Knowledge of the Affordable Care Act

ANALYSIS

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

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.

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  • Abortion Coverage in the ACA Marketplace Plans: The Impact of Proposed Rules for Consumers, Insurers and Regulators

    Issue Brief

    On November 7, 2018, a day after the 2018 midterm elections, the Trump Administration issued a proposed regulation to address “Exchange Program Integrity.” A major element of this proposed rule would affect insurers, consumers, and state insurance regulators in the states that either allow or require abortion coverage. The Affordable Care Act (ACA) allows states to ban plans from offering abortion as a benefit on their Qualified Health Plans (QHPs) and requires plans that cover abortion to segregate policyholder payments for abortion coverage from all other premium charges. This brief provides an overview of current ACA-related abortion coverage policies and analyzes the potential impact of the proposed changes.

  • How Many of the Uninsured Can Purchase a Marketplace Plan for Free?

    Issue Brief

    This analysis looks at how many of the remaining uninsured are eligible for premium subsidies that are large enough to cover the entire cost of a bronze plan, which is the minimum level of coverage available on the Marketplaces. It estimates 27% of uninsured individuals who could shop on the ACA Marketplace, or 4.2 million people nationwide, are eligible to purchase a bronze plan with $0 premiums after subsidies in 2019.

  • New Rules for Section 1332 Waivers: Changes and Implications

    Issue Brief

    On October 22, 2018, the Trump administration released new guidance on Section 1332 waivers established by the Affordable Care Act (ACA). The new guidance may encourage states to use 1332 waiver authority to make broader changes to insurance coverage for their residents, including to promote the sale of, and apply subsidies to, ACA non-compliant policies. On November 29, 2018, the Centers for Medicare and Medicaid Services (CMS) released a discussion paper outlining a set of waiver concepts designed to provide states with a roadmap for developing waiver applications that use the flexibility granted under the new guidance. This issue brief describes the new guidance, highlighting key changes from the 2015 guidance, describes how state waiver activity may change, particularly in light of the waiver concepts put forward by CMS, and discusses possible implications of the changes.

  • Bipartisan Majorities Support Trump Administration’s Push to Get Drug Prices in Advertisements, Even after Hearing Counter-Arguments

    News Release

    Only 1 in 4 Potential Marketplace Customers Know When ACA Open Enrollment Ends; 1 in 5 Say They Would Buy a Short-Term Plan A large majority of the public backs the Trump Administration’s initiative to require prescription drug advertisements to include information about prices, but fewer support other administrative actions involving pre-existing conditions and contraception…

  • KFF Health Tracking Poll – November 2018: Priorities for New Congress and the Future of the ACA and Medicaid Expansion

    Feature

    Fielded a week after the 2018 midterm elections, this poll examines the public’s priorities for the next Congress, measures favorability for ACA provisions including Medicaid expansion, and takes a look at knowledge of the current open enrollment period among adults ages 18-64 who purchase their own insurance or are currently uninsured. With the impending Texas v. United States lawsuit, in addition to several Trump administration policy actions aimed at different aspects of the U.S. health care system, this KFF survey also examines the public’s position on pre-existing conditions protections, prescription drug advertisements, and employer exemptions from covering birth control.