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.
Affordable Care Act
The ACA Marketplace
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.”
new and noteworthy
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.
Timely insights and analysis from KFF staff
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More Than Half of ACA Marketplace Enrollees Live in Republican Congressional Districts
Since the enhanced premium tax credits became available in 2021, ACA Marketplace enrollment has increased significantly in some red states, and 57% of enrollees now live in Republican congressional districts. ... more
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If Enhanced ACA Tax Credits Expire, Older Marketplace Enrollees Face Steepest Premium Hikes
The ACA enhanced premium tax credits expanded financial assistance to more Marketplace enrollees, an expansion that was especially helpful to older middle-income enrollees, who would see the largest increases in out-of-pocket premiums if the enhanced credits expire. ... more
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More Than 3 in 4 ACA Marketplace Enrollees Live in States Won by President Trump in 2024
As Democrats push for an extension of the ACA’s enhanced premium tax credits, new data from KFF show the extent to which states won by Trump in 2024 have come to rely on the ACA Marketplaces and the tax credits, which make health care coverage more affordable for low- and middle-income Marketplace enrollees. ... more
Jared Ortaliza 
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