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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.

Health Coverage Among Community Health Center Patients, 2019-2024

Community Health Center Patients, Financing, and Services

Changes to Medicaid and the ACA Marketplace included in the 2025 reconciliation law and the expiration of ACA Marketplace enhanced premium tax credits at the end of 2025 are likely to increase the number of uninsured patients and patients who cannot afford out-of-pocket costs, placing new financial burdens on community health centers.

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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  • Kaiser Health Tracking Poll: November 2014

    Feature

    Following the Nov. 4 midterm elections, nearly half of Americans expect increased debate between the two parties over the Affordable Care Act. In comparison, 42 percent say the amount of debate will not change, and very few (5%) say it will decrease. Conducted just prior to the start of the ACA's second open enrollment season, the poll also probes the views of people without health insurance, one of the key target groups for outreach and enrollment efforts. It finds the uninsured remain largely unaware of the renewed opportunity to purchase or enroll in health insurance through the marketplaces over the next few months.

  • Early Impacts of the Medicaid Expansion for the Homeless Population

    Issue Brief

    This analysis provides an early look at the impact of the expansion for homeless providers and the patients they serve. It is based on focus groups conducted with administrators, providers, and enrollment workers at four sites serving homeless individuals in states that have expanded Medicaid (Albuquerque, NM; Baltimore, MD; Chicago, IL; and Portland, OR) and one site in a state that has not expanded (Jacksonville, FL), as well as administrative data collected from the sites.

  • Data Note: 5 Misconceptions Surrounding the ACA

    Feature

    On the seventh anniversary of the passing of the Affordable Care Act, this Data Note highlights five of the most common misconceptions surrounding the 2010 health care law.

  • Kaiser Health Tracking Poll: December 2015

    Feature

    The ACA’s third open enrollment will come to a close at the end of January and the December Kaiser Health Tracking Poll finds that only 7 percent of the uninsured correctly identify this as the deadline to enroll in coverage. With Democratic presidential candidates debating the idea of Medicare-for-all, which involves creating a national health plan in which all Americans would get their insurance through an expanded version of the Medicare program, most Democrats like the idea, but very few say the issue will drive their votes in the 2016 elections. As the U.S. Senate voted to repeal the Affordable Care Act (ACA) earlier this month, more of the public views the health care law unfavorably than favorably (46 percent vs. 40 percent). In addition, the public remains divided over what Congress should do next with the law, with 35 percent supporting repeal, 14 percent supporting scaling back the law, 18 percent who say they would like to see it implemented as is, and 22 percent who say they want the law expanded.

  • 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.

  • 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.

  • Majority of Public Says Congress Should Act to Close Gaps if the Supreme Court Bars Financial Help for Purchasing Insurance in States Relying on healthcare.gov; Most in Potentially Affected States Want Their State To Set Up Its Own Marketplace if Needed

    News Release

    Views Mixed on Changes to Definition of Full-Time Work For Employer Mandate, with More Opposed than Supportive, And a Third Saying They Don't Know Enough to Say Public Remains Divided Over Next Steps for the Affordable Care Act, Though Most Expect Major or Minor Changes under GOP Congress this Year Though few Americans are paying…

  • 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.