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The ACA Marketplace

2025 KFF Marketplace Enrollees Survey

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, according to a KFF survey conducted in 2025.

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Tracking the Public’s Views on the ACA

While overall opinion of the Affordable Care Act has been more favorable than unfavorable since 2017, there remain deep partisan divides. See how public opinion on the ACA has changed from the inception of the law to the present. This interactive tool highlights key moments when views shifted and trends based on party identification, income, age, gender, and race/ethnicity.

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  • Massachusetts and Ohio: Capitated Financial Alignment Demonstrations for Dual Eligible Beneficiaries Compared

    Fact Sheet

    The Centers for Medicare and Medicaid Services (CMS) has finalized memoranda of understanding (MOUs) with Massachusetts and Ohio to test a capitated financial alignment model to integrate care and align financing for people who are dually eligible for Medicare and Medicaid in 2013. CMS also has signed an MOU with Washington to test a managed fee-for-service model. These three year demonstrations will introduce changes in the care delivery systems through which beneficiaries presently receive services…

  • Pulling It Together: Are We Headed for a Government Takeover of Health Care?

    Perspective

    Remember the “government takeover of the health care system” argument that critics of the health reform law have used?  Well, last week the Office of the Actuary in the Centers for Medicare and Medicaid Services published the latest projections of health spending in the journal Health Affairs.  Attention focused mainly on the Actuary’s estimate that national health spending would grow to almost 20% of GDP by 2020 and that the Affordable Care Act (ACA) would…

  • California's "Bridge to Reform" Medicaid Demonstration Waiver

    Fact Sheet

    This issue brief provides an overview of California's "Bridge to Reform" Medicaid Demonstration Waiver, which was approved in 2010 and will make up to roughly $8 billion in federal Medicaid matching funds available to California over a five-year period to expand coverage to low-income uninsured adults and preserve and improve the county-based safety-net. The waiver also allows the state to enroll Medicaid-eligible seniors and persons with disabilities into managed care plans that meet specified readiness…

  • The Health of Safety-Net Hospitals: How are They Faring? What’s the Outlook?

    Event Date:
    Event

    The Alliance for Health Reform and The Commonwealth Fund discusses the critical role of safety-net hospitals in providing care to vulnerable populations. Panelists will explore such questions as: Who does the safety-net system currently serve and how will this patient mix change as the health reform law plays out? How are safety-net hospitals faring in the current economic environment and how are they altering the way they provide care? How are states and safety-net systems…

  • The Coverage and Cost Impacts of Expanding Medicaid

    Report

    This paper quantifies the impacts on coverage and cost of expanding Medicaid to cover more of the low-income uninsured, including adults, at various income levels and with improved participation rates. The analysis models two primary options to expand Medicaid (250% FPL for children, 100% FPL for adults; 300% FPL for children, 150% for adults) as well as the same options with no change for children. Report (.pdf)

  • Rising Health Pressures in an Economic Recession: A 360-Degree Look at Four Communities

    Report

    This report draws on interviews and focus groups in four communities to examine at the grassroots levels the experiences of families, employers, safety-net providers and community organizations in four U.S. communities hard hit by the recession. The communities are Beloit, Wisc.; Tampa-St. Petersburg, Fla.; Long Island, N.Y.; and Sonoma, Calif. The report explores the financial and personal struggles of families who have suffered economic reversals and lost health coverage, forcing many to juggle bills and…

  • Pulling It Together: Predictions

    Perspective

    I usually don’t make predictions, unless they are backed up by the kind of statistical modeling we often produce.  But here are three predictions I am confident about that form the basis of this latest column. GROUP HEALTH INSURANCE PREMIUMS WILL CONTINUE TO RISE AT HISTORICALLY MODERATE LEVELS, AT LEAST FOR THE NEXT FEW YEARS.  One reason for this is the lingering effect of the recession.  Employers will have little trouble attracting workers in the…

  • Explaining Health Reform: The New Rules for Determining Income Under Medicaid in 2014

    Issue Brief

    To provide individuals and families access to affordable, high-quality health care, the Patient Protection and Affordable Care Act (ACA) expands Medicaid to cover low-income adults and children with incomes up to 133 percent of the poverty line. Millions of low-income parents, non-disabled adults who do not have dependent children (and who are generally ineligible for Medicaid today except in a small number of states) and, in some instances, children now covered through the Children’s Health…

  • Pulling It Together: Changing the HIV Testing Message

    Perspective

    In 2006 the CDC began recommending routine HIV testing in health care settings for everyone between the ages of 13 and 64. Annual  testing is recommended for people at highest risk. Our 2011 survey of Americans and HIV released last week -- our eighth comprehensive survey of its kind --  shows that more people are talking with their doctors about being tested for HIV, but that reported rates of actually getting tested have remained virtually…