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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This analysis details the number of people who would become uninsured from policy changes in the ACA Marketplaces and Medicaid. The Congressional Budget Office estimates that, taken together, these changes will result in 16 million more uninsured people in the year 2034 than would otherwise be the case.
In a new column, Dr. Drew Altman, KFF’s President and CEO, discusses the limits of polling on policy, and what we have learned over more than 30 years of polling about how giving people more information and arraying tradeoffs can change opinion, including on the health policy changes and funding cuts in the current reconciliation bill.
KFF's Health Tracking Poll looks at public awareness and support for ACA Marketplace subsidies and finds that most adults are unaware the subsidies are set to expire soon. Three in four say Congress should extend the subsidies and support persists despite hearing counter arguments.
With the Affordable Care Act’s (ACA) enhanced premium tax credits set to expire at the end of 2025, a large majority (77%) of the public favor Congress extending the credits while about one in five (22%) say they should let them expire, the latest KFF Health Tracking Poll finds.
This poll finds two-thirds of the public view the "One Big Beautiful Bill" legislation unfavorably, and its favorability erodes further when people hear about its potential health impacts. As Congress debates changes to Medicaid and the ACA as part of the bill, each program's popularity is at a record high.
Medicaid Work Requirements Are Generally Popular, But Arguments Can Shift Views Nearly two-thirds (64%) of the public holds unfavorable views of the “One Big Beautiful Bill” passed last month by the House, nearly twice the share who view the bill favorably (35%), a new KFF Health Tracking Poll finds.
Taken together, the reconciliation bill's provisions impose additional administrative burdens on state-based marketplaces and could limit state flexibility in choosing marketplace policies and procedures.
This chart examines individual market enrollment data from 2011 through 2025, when enrollment reached a record high of 25.2 million people. Affordable Care Act (ACA) Marketplace enrollment increased following the enactment of enhanced premium tax credits in 2021, as more individuals became eligible for subsidies.
Through regulations and the House budget reconciliation bill, significant changes are being considered by Congress and the Trump Administration for how the Affordable Care Act’s health insurance Marketplaces would work. To examine how these changes could reshape the ACA’s Marketplaces, KFF held a virtual briefing on June 11 featuring leaders from two state-based Marketplaces to get perspectives from the field.
In his latest column, President and CEO Drew Altman discusses how, with nearly half, or about 10 million MAGA supporters and Republicans receiving coverage through the ACA Marketplaces, the policy changes and cuts being considered by Republicans to the Marketplaces will directly affect their own voters. Altman writes: "Republicans are no longer interested in repealing the ACA but seem comfortable shrinking it significantly if they can, so long as they don’t touch protections for pre-existing conditions, which is now a political third rail."
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