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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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  • Making the Marketplaces Great Again?

    From Drew Altman

    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."

  • How the Trump Administration and Congress Are Reshaping the Affordable Care Act’s Marketplaces: Views from the States

    Event Date:
    Event

    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.

  • The Spotlight Is on Medicaid Cuts, But the ACA Marketplaces Could See a One-Third Cut in Enrollment

    From Drew Altman

    In his latest column, President and CEO Drew Altman shows how proposals contained in the House reconciliation bill could result in a one-third reduction in ACA Marketplace enrollment. “While all eyes are on the big Medicaid cuts being proposed in the House,” he writes, “significant changes are also being proposed that together would dramatically reduce enrollment in the ACA Marketplaces.”

  • Could Trump Walk Away from Unpopular Health Proposals?

    From Drew Altman

    In a new column, KFF President and CEO Drew Altman discusses what President Trump’s decision to pull back the broad freeze in federal grant funding might portend for his response to future policies in health that prove controversial or unpopular.

  • What’s Next for the Affordable Care Act?

    Event Date:
    Event

    Health coverage enrollment through the ACA marketplaces now exceeds 24 million people, a dramatic increase in recent years fueled largely by enhanced premium aid. With the subsidies set to expire at the end of this year, Congress and the Trump Administration will be faced with a choice of whether and how to extend the subsidies, alongside broader discussion about the budget. On February 10, KFF’s Larry Levitt moderated a 45-minute virtual discussion with an expert panel to explore these questions and more about the future of the ACA.

  • ACA Preventive Services at the Supreme Court

    Quick Take

    If the Court rules in favor of Braidwood, private health insurers would no longer be required to cover, without cost sharing, certain preventive services recommended by USPTF after 2010 when the ACA was enacted.

  • What did Sen. JD Vance mean by ‘Reinsurance?’

    Quick Take

    Vance’s debate comment likely refers to state reinsurance waivers, largely approved by the Trump Administration. These waivers aimed to lower unsubsidized premiums by offsetting insurer costs for very sick enrollees.