KFF

About 1 in 10 Marketplace enrollees dropped their ACA coverage and are now uninsured and nearly 3 in 10 changed Marketplace plans, our latest survey shows. When asked about what influenced their decision, most say their plan being too expensive was a “major reason.” on.kff.org/3NKfN84

Simplest math ever. A 200 bill Iran war special appropriation = almost six years of extended ACA tax credits.

Our latest survey shows that Marketplace enrollees are concerned about their ability to pay for both routine and unexpected medical expenses. See the details in our full report: on.kff.org/3NKfN84

“The impacts on Marketplace enrollees we see in this follow-up survey will likely get worse as people struggle to make payments and the grace period many have expires,” KFF President and CEO @DrewAltman said. Read more from our latest survey: on.kff.org/3NKfN84

With limited federal data available so far, our follow-up survey of ACA enrollees is the best information on how much more people are paying with enhanced tax credits expired, how many are switching to higher deductible plans, and how many are uninsured. kff.org/public-opinion…

A majority of those who re-enrolled in an ACA Marketplace plan say they have cut or plan to cut spending on food or other basic household expenses to afford their health care costs. The impact is even greater for those with chronic health conditions: on.kff.org/3NKfN84

Impacts of the enhanced premium tax credit expiration are beginning to show - NINE PERCENT of people who had ACA coverage in 2025 are uninsured now. Many were faced with zero affordable insurance options. Only 39% stayed enrolled in the same ACA plan (61% made changes!). @KFF

We re-surveyed Marketplace enrollees who shared their expectations for coverage decisions late last year. Our latest findings show that nearly 1 in 6 returning ACA Marketplace enrollees say they’re not confident they’ll be able to afford their premiums this entire year. on.kff.org/3NKfN84

Our new follow-up survey of ACA enrollees as enhanced tax credits expire finds they’re paying more for health care and cutting back on household spending. Nine percent are already uninsured, and that number is sure to grow.

NEW. Marketplace enrollees are dropping coverage and switching to higher deductible plans, but the biggest effect of not extending the credits: more than half say they can’t afford food and other essentials because they have higher health costs. on.kff.org/3NKfN84

NEW: A 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. This includes 4 in 10 who specifically say this about their premiums. on.kff.org/3NKfN84

Medicaid spending on prescription drugs is both a state and federal policy focus. Net spending on prescription drugs grew by 46% between FY 2019 and FY 2024, similar to the period’s overall Medicaid spending growth (52%): on.kff.org/4rM7abe

You likely encounter these health insurance terms every year during open enrollment, but how confident are you in what they mean? Take our 10-question quiz and see how you score: on.kff.org/healthinsuranc…

Health care and pharmaceutical companies are among the earliest adopters of a practice called “generative engine optimization” (GEO). Our most recent edition of The Monitor tackles what that means for your health information. on.kff.org/3NoALcw

Our updated calculator uses NEW data for 2026 to estimate health insurance premium payments and subsidies for people purchasing insurance in the ACA Marketplaces: on.kff.org/3UysqTN

One of the limitations of TrumpRx is that it's only for people who pay for drugs not using their insurance. Of course, more people will be doing that as the number of uninsured increases by an estimated 14 million with Medicaid cuts and expiration of enhanced ACA subsidies.

Our updated analysis describes recent trends in the number of Medicaid outpatient prescriptions and spending on those drugs, and also examines the implications of recent federal policy actions: on.kff.org/4rM7abe

What we’re watching: The EPA has launched the next step in its review of fluoride safety as more states move to ban water fluoridation. The review arrives as senior officials amplify concerns about fluoride that go beyond what the current evidence supports. on.kff.org/3NoALcw

⚡ KFF’s @jenkatesdc provides background about yesterday’s court ruling which halts some of the Trump administration’s changes to federal vaccine recommendations. #QuickTake on.kff.org/4sQiTWP

How much are Marketplace enrollees paying in premiums this year without the ACA's enhanced premium tax credits? Our updated Health Insurance Marketplace Calculator can provide insights: on.kff.org/3UysqTN