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Affordable Care Act

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.

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

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  • Data Note: Attempting to Measure Early Impact of the ACA through National Public Opinion Polls- A Note of Caution and What to Watch For

    Feature

    After the October start of open enrollment, under the Affordable Care Act, many journalists, policymakers, and the public at large are eager for early data indicating how the law is working from the perspective of potential enrollees. In particular, given the problems with Healthcare.Gov and some of the state exchange websites, many people want quantitative data about people’s experiences attempting to purchase or enroll in some sort of health insurance coverage using these mechanisms.
    This Data Note raises a note of caution about the possible pitfalls of using standard national public opinion polls to make judgments about Americans’ early experiences with health plan enrollment under the ACA.

  • How Will the Uninsured in Delaware Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in Delaware, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Delaware are eligible for Medicaid or financial assistance in the Marketplace. For states not expanding Medicaid, the report quantifies how many uninsured people fall into the “coverage gap,” meaning they will be ineligible for financial assistance in the Marketplace or for Medicaid in their state despite having an income below the federal poverty level.

  • How Will the Uninsured in Indiana Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in Indiana, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Indiana are eligible for Medicaid or financial assistance in the Marketplace. For states not expanding Medicaid, the report quantifies how many uninsured people fall into the “coverage gap,” meaning they will be ineligible for financial assistance in the Marketplace or for Medicaid in their state despite having an income below the federal poverty level.

  • How Will the Uninsured in Washington Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in Washington, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Washington are eligible for Medicaid or financial assistance in the Marketplace. For states not expanding Medicaid, the report quantifies how many uninsured people fall into the “coverage gap,” meaning they will be ineligible for financial assistance in the Marketplace or for Medicaid in their state despite having an income below the federal poverty level.

  • Data Note: How Many People Have Nongroup Health Insurance?

    Issue Brief

    The implementation of the Affordable Care Act (ACA) has focused attention on the composition of the nongroup market: how it looked before the new regulatory provisions take effect and how it will change afterwards. There are several ways of answering this question, depending on the time period for measuring enrollment and the information source. There is substantial turnover among people with nongroup coverage, which means that the number of people covered at the beginning of a year (or at any other point in time) is quite different than the number of people who keep that coverage throughout the whole year.

  • How Affordable are 2019 ACA Premiums for Middle-Income People?

    Issue Brief

    This analysis finds that Affordable Care Act marketplace premiums are least affordable for older adults who earn too much to qualify for federal subsidies, especially those living in rural areas where premiums are highest. The analysis also discusses a variety of state and federal proposals that seek to lower premiums for middle-class people buying their own insurance who are ineligible for ACA subsidies.

  • Poll: Most Americans Say HIV Is Serious Issue for the Country as Trump Administration Rolls Out New Plan to End HIV by 2030; Black and Hispanic Adults Report More Personal Concern than White Adults

    News Release

    Support for Medicare-for-all Holds Steady With the Trump administration launching a new domestic HIV effort, the latest KFF Health Tracking Poll finds a large majority of Americans (80%) view the HIV epidemic as a serious national issue, including a third (34%) who view it as “very serious.

  • The Effects of Medicaid Expansion under the ACA: Studies from January 2014 to January 2020

    Report

    This literature review summarizes findings from 404 studies of the impact of state Medicaid expansions under the ACA published between January 2014 (when the coverage provisions of the ACA went into effect) and January 2020. It includes studies, analyses, and reports published by government, research, and policy organizations using data from 2014 or later. This body of research suggests that the expansion presents an opportunity for gains in coverage, improvements in access and financial security, and economic benefits for states and providers.

  • The Affordable Care Act’s Enduring Resilience

    Perspective

    In this article in the Journal of Health Politics, Policy and Law, Larry Levitt examines the Affordable Care Act 10 years after it's enactment. The article notes that the law has taken numerous blows, yet due to its policy design and the political forces it has unleashed, the law has shown remarkable resilience.