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The Enhanced Premium Tax Credits

About Half of Adults with ACA Marketplace Coverage are Small Business Owners, Employees, or Self-Employed

About Half of Adults with ACA Marketplace Coverage are Small Business Employees or Self-Employed and Could Face Higher Premiums Soon

About half (48%) of adults with ACA Marketplace coverage are employed by small businesses or are self-employed and could face higher premiums soon. Because the vast majority of individual market coverage is purchased through the Affordable Care Act (ACA) Marketplaces, changes to the ACA, including the expiration of the enhanced premium tax credits at the end of this year, would have significant implications for what small business owners and workers spend on their health care.

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ACA Marketplace Plans Nationally Are Seeking a Median 18% Premium Increase for 2026

This analysis of insurers’ initial rate filings for Affordable Care Act Marketplace plans in all 50 states and DC finds the median proposed increase for 2026 is 18%, more than double last year’s proposed increase. The analysis also shows proposed rate changes by state and insurer.


Tariffs Are Driving up Premiums for Small Businesses

Estimates of Additional Uninsured People Across the States

ACA Provisions in the 2025 Federal Budget Reconciliation Law

Health Insurance Marketplace Calculator

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  • How the Loss of Cost-Sharing Subsidy Payments is Affecting 2018 Premiums

    Issue Brief

    This analysis of 32 states and Washington, D.C., tracks data on 2018 Affordable Care Act (ACA) marketplace premium increases that insurers directly attributed to the end of cost-sharing reduction payments, which reimburse insurers for providing marketplace health plans with reduced out-of-pocket costs for lower-income people. Following months of uncertainty, the Trump administration announced on Oct. 12 that the payments would be discontinued immediately, although insurers must still offer the subsidized coverage.

  • Kaiser Health Tracking Poll – July 2018: Changes to the Affordable Care Act; Health Care in the 2018 Midterms and the Supreme Court

    Feature

    The July 2018 Kaiser Health Tracking Poll finds that a candidate's position on continuing coverage for pre-existing conditions tops voters' list of priorities when it comes to who they'll vote for in the 2018 midterms. Additionally, 6 in 10 Americans say President Trump and his administration are trying to make the Affordable Care Act fail, and about half say that this is a bad thing.

  • The Politics of ACA Rate Hikes Will Be 2016 in Reverse

    From Drew Altman

    Democrats are expected to turn the tables and attack Republicans for rising premiums and sabotaging the Affordable Care Act. In his Axios column, Drew Altman discusses a balancing act they face which has not received attention: score political points, but run the risk of a new debate scaring the broader public and undermining the ACA by focusing on its continuing problems.

  • Kaiser Health Tracking Poll: Preview of the Role of Health Care in the 2018 Midterm Campaigns

    Feature

    The latest KFF Health Tracking Poll finds health care ranking among the top issues voters want to hear candidates talk about during their congressional campaigns, with health care cost ranking as the top health care issue for voters across partisanship. However, for many voters, including one-third of Republican voters, a candidate’ position on President Trump will make the biggest difference in how they vote in 2018. This month’s poll also takes an in-depth look at voters who say a candidate’s position on health care will be the “most important factor” in their 2018 congressional vote choice, otherwise known as “health care voters.”

  • Kaiser Health Tracking Poll – August 2017: The Politics of ACA Repeal and Replace Efforts

    Feature

    Following the U.S. Senate’s failed vote on the “skinny repeal”, the latest Kaiser Health Tracking Poll finds that the majority of the public say it is a “good thing” that the Senate did not pass the bill that would have repealed and replaced the ACA. A large share of Americans think President Trump and his administration should do what they can to make the current health care law work and a majority of the public want to see bipartisan efforts to improve the 2010 health care law. However, about half of Republicans and Trump supporters would like to see Republicans in Congress keep working on a plan to repeal the ACA, and most Republicans and Trump supporters endorse using hard-ball tactics to encourage Democrats to start negotiating with President Trump on a replacement plan. The majority of the public are also unaware that health insurance companies choosing not to sell insurance plans or charging higher premiums in certain marketplaces only affect those who purchase their own insurance on these marketplaces.