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2025 KFF Marketplace Enrollees Survey

If the amount they pay in premiums doubled, about one in four enrollees in ACA Marketplace health plans say they would “very likely” go without insurance in 2026, finds a KFF survey of Marketplace enrollees fielded shortly after open enrollment began in the first weeks of November 2025. One in three say they would be “very likely” to look for a lower-premium Marketplace plan.

Data and analysis

The Uninsured Population and Health Coverage

This Health Policy 101 chapter examines the share of the United States population who are uninsured, highlighting their demographics and the challenges they face because of the lack of coverage.

How Many Uninsured Are in the Coverage Gap?

This analysis estimates that 1.4 million uninsured individuals in the 10 states without Medicaid expansion, including many working adults, people of color, and those with disabilities, remain in the “coverage gap,” ineligible for Medicaid or for tax credits that would make coverage ACA's Marketplaces affordable to them.

Key Facts about the Uninsured Population

The number of people ages 0-64 who were uninsured held steady at 25.3 million in 2023, although the number of uninsured children rose from 3.8 million to 4.0 million. Most uninsured people are in low-income families and have at least one worker in the family.

How the Unwinding Affected Enrollees

Over half who were disenrolled say they put off needed medical care while trying to renew Medicaid. Overall, 19% of adults who had Medicaid prior to the start of unwinding say they were disenrolled at some point in the past year. Of this group, a large majority (70%) were left at least temporarily uninsured.

The uninsured: How costs affect care and health, 2023

Latest Polling
8%

Percent of adults who reported not having health insurance
55%

Percent of uninsured adults who reported delaying or forgoing some form of health care due to cost
19%

Percent of uninsured adults who report that they or a family member had difficulty paying medical bills
38%

Percent of uninsured adults who reported not having a usual source of care (vs. 8% of insured adults)
Peterson-KFF Health System Tracker

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  • Web Briefing: What Worked, What’s Next? Strategies in Four States Leading ACA Enrollment Efforts

    Event Date:
    Event

    On Monday, July 28, the Kaiser Family Foundation held an interactive web briefing to examine the experiences and lessons of four states -- Colorado, Connecticut, Kentucky, and Washington -- that each established state-based Marketplaces, expanded their Medicaid programs, and successfully enrolled eligible individuals into Medicaid and Marketplace coverage under the ACA.

  • Declines in Uncompensated Care Costs for The Uninsured under the ACA and Implications of Recent Growth in the Uninsured Rate

    Issue Brief

    The increase in the uninsured rate in recent years, as well as loss of coverage during the pandemic, has led to attention on the consequences of being uninsured. The need for medical care to test, treat, or prevent COVID-19 has also highlighted the potential consequences of uncompensated care for uninsured people. Uncompensated care costs occur because, although people who are uninsured use less care than people with coverage, most who are uninsured have limited income or resources and cannot afford the high cost of medical care, if and when they do need or use health care.

  • Kaiser Health Tracking Poll: January 2015

    Feature

    The latest Kaiser Health Tracking Poll finds though few Americans are paying attention to the pending Supreme Court case over whether the health care law says that people in all states can get financial help to buy health insurance, most say they would want Congress and their state to act to fix potential gaps should the Supreme Court rule in favor of the plaintiffs. With a new Republican majority controlling both Houses of Congress, the public remains divided on what they would like Congress to do next with the Affordable Care Act (ACA) overall. About a third (32%) say they favor repeal, another 14 percent would like the law scaled back, 19 percent want the law to move forward as is, and nearly a quarter (23%) would like to see the law expanded.

  • The Health-Care Enrollment Story Is in the States

    News Release

    In his latest column for The Wall Street Journal's Think Tank, Drew Altman examines the variation among states beneath the national Affordable Care Act’s Marketplace enrollment numbers released by the U.S. Department of Health and Human Services. All previous columns by Drew Altman are available online.

  • Kaiser Health Tracking Poll: November 2015

    Feature

    As the problem of prescription painkiller abuse has captured greater attention from policymakers and the media, the November Kaiser Health Tracking Poll explores the public’s connection to and knowledge of the issue, as well as their views of how to address it. A surprising 56 percent of the public say they have some personal connection to the issue – either because they say they know someone who has taken a prescription painkiller that wasn’t prescribed to them, know someone who has been addicted, or know someone who has died from a prescription painkiller overdose. While views of the health care law have been narrowly divided for much of the year, this month more say they have an unfavorable view of the law than a favorable one. The poll also includes views of the uninsured during the third open enrollment period under the health care law.