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Affordable Care Act

Enhanced Premium tax credits

2025 KFF Marketplace Enrollees Survey

If the amount they pay in premiums doubled, about one in three enrollees in Affordable Care Act Marketplace health plans say they would be “very likely” to look for a lower-premium Marketplace plan.

An image of text is an excerpt form Larry Levitt's quick take which reads, "While the enhanced ACA premium tax credits expire at the end of this year, there is no absolute drop-dead date for extending them. ACA enrollees would welcome premium relief whenever it comes."

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.

ACA Marketplaces

Competition Has Increased in the Individual Market But Fallen in Fully Insured Group Markets

Commercial health insurance markets remain highly concentrated across coverage types. However, the individual market, which consists mostly of the ACA Marketplaces, has attracted more insurers and witnessed greater insurer competition across a variety of measures since the implementation of the enhanced premium tax credits in 2021, according to a new Healthy System Tracker analysis.


ACA Premium Payment Increases Across Congressional Districts

Some Price-Sensitive Consumers May Consider Switching to Short-Term Plans

Marketplace Enrollment Snapshot for Open Enrollment 2026

Number of Insurers in the Individual Insurance Marketplaces

Timely insights and analysis from KFF staff

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  • Poll: Democrats Say They Are Hearing Enough From Presidential Candidates About Medicare-for-All and Expanding Coverage, But Want Them to Talk More about Health Costs and Women’s Health Care

    News Release

    Heading into tonight’s Democratic primary debate, most Democrats and Democratic-leaning independents say the candidates are spending the right amount or too much time talking about ways to provide coverage to more Americans and Medicare-for-all, two topics that have dominated health care discussions in the past three rounds of Democratic debates, the latest KFF Health Tracking…

  • Key State Policy Choices About Medical Frailty Determinations for Medicaid Expansion Adults

    Issue Brief

    This issue brief answers 3 key questions and provides new data about state medical frailty determinations, which are assuming greater importance as more states adopt restrictive Section 1115 waivers that exempt medically frail enrollees from policies such as work requirements and premiums. The findings are excerpted from our 50-state survey on Medicaid financial eligibility for seniors and people with disabilities.

  • How Many Employers Could Be Affected by the High-Cost Plan Tax

    Issue Brief

    The high cost plan tax (HCPT) sometimes referred to as the Cadillac tax, is an excise tax on the cost of employer health benefit exceeding certain threshold. The HCPT provides a powerful incentive to control health plans costs over time, whether through efficiency gains or shifts in costs to workers. While many employers do not expect that the tax will take effect in 2022, others are already amending their health programs in anticipation. We estimate if the tax takes effect in 2022, 21% will be subject to the tax, increasing to 37% by 2030 unless firms reduce costs. Larger shares would be affected when counting workers' voluntary contributions to Flexible Spending Accounts (FSAs)

  • State Actions to Improve the Affordability of Health Insurance in the Individual Market

    Issue Brief

    A number of states have taken steps to provide consumers with more affordable coverage options in the individual market, including the marketplaces. Some states are implementing strategies that lower premiums by building on, and increasing the stability of the individual market, while other states are expanding the availability of lower cost coverage sold outside the marketplaces that does not comply with ACA standards—an approach that could increase marketplace premiums further. This brief examines these different approaches and discusses the implications of state policy choices.

  • 10 Key Questions on Public Option Proposals

    Issue Brief

    This issue brief presents ten, high-level key questions regarding current public option proposals supported by both Democratic presidential candidates and Members of Congress.

  • Universal Coverage May Not Mean Everyone Has Health Insurance

    From Drew Altman

    Universal coverage is a big and important goal. But would absolutely everyone be covered under current proposals? Is it a better rallying cry for Democrats in the primaries or the general election? Drew Altman analyzes these questions in an Axios column.