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Affordable Care Act

The ACA Marketplace

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.

Cost Concerns and Coverage Changes: A Follow-Up Survey of ACA Marketplace Enrollees

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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POLLING

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.
DATA

Marketplace Enrollment is Down in 2026—But All of the Data Isn’t in Yet

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

Timely insights and analysis from KFF staff

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  • State-by-State Estimates of Changes in Federal Spending on Health Care Under the Graham-Cassidy Bill

    Issue Brief

    A new health care bill recently introduced by a number of senators led by Senators Lindsey Graham and Bill Cassidy would repeal major elements of the Affordable Care Act (ACA), make changes to other ACA provisions, and fundamentally alter federal Medicaid financing. In this brief, we estimate changes in federal funding due to the new block grant program and the Medicaid per enrollee cap on a state-by-state basis under the Graham-Cassidy bill relative to current law. We estimate that the Graham-Cassidy proposal would reduce federal funding for health coverage by $161 billion nationally from 2020-2026, with substantial variation across states.

  • Favorability of the Affordable Care Act Tops 50%, While Across Many Measures, Majorities Oppose the Republican Plan to Replace It

    News Release

    Three-Quarters of the Public, Including Most Republicans, View Medicaid Favorably; Most Oppose Federal Funding Cuts to States As the Senate prepares to vote on the Republican bill to repeal and replace the Affordable Care Act and cap federal Medicaid funding, a new Kaiser Family Foundation Tracking Poll finds most Americans oppose the Republican plan and…

  • Compare Proposals to Replace The Affordable Care Act

    Interactive

    President Donald Trump and Republicans in Congress have committed to repealing and replacing the Affordable Care Act (ACA). How do their replacement proposals compare to the ACA? How do they compare to each other? Includes the Graham-Cassidy-Heller-Johnson amendment (introduced 9/13/2017) as well as other proposals from key members of Congress.

  • What’s Really At Stake In the Medicaid Spending Debate

    From Drew Altman

    In this Axios column, Drew Altman highlights that the federal debate about the American Health Care Act’s Medicaid spending reductions will ultimately be a debate about every state’s general budget spending priorities, as states discuss whether to offset reductions in federal revenues with some combination of cuts to their Medicaid programs, increased taxes, and cuts to spending in other areas.

  • 5 Ways the Graham-Cassidy Proposal Puts Medicaid Coverage At Risk

    Fact Sheet

    The Graham-Cassidy proposal to repeal and replace the Affordable Care Act (ACA) is reviving the federal health reform debate and could come up for a vote in the Senate before the budget reconciliation authority expires on September 30. This fact sheet describes five ways in which the proposal revamps and cuts Medicaid, redistributes federal funds across states and eliminates coverage for millions of poor Americans.

  • Implications of Emerging Waivers on Streamlined Medicaid Enrollment and Renewal Processes

    Fact Sheet

    The Affordable Care Act (ACA) significantly modernized and streamlined Medicaid enrollment and renewal processes across all states. Through major investments of time, money, and staff, most states have implemented modernized systems that transformed lengthy, paperwork driven enrollment and renewal procedures to a simplified, technology-driven experience that minimizes burdens on individuals and states. Recently approved and proposed waivers and other proposed policies include new eligibility and enrollment requirements and restrictions that run counter to the ACA’s streamlined processes (Figure 1). This fact sheet provides an overview of how enrollment and renewal processes changed under the ACA and the implications of emerging waivers and other proposed changes on streamlined enrollment and renewal.

  • Health Coverage and Care in the South in 2014 and Beyond

    Issue Brief

    This issue brief provides an overview of health coverage and care in the South today, with a focus on demographics, the impact of the ACA coverage expansions, and ongoing efforts to improve the delivery system and safety net in the South.