Every summer, health insurers file proposed premiums with state regulators, and every fall those numbers become real when open enrollment opens. The 2027 filings are now largely finalized, and they confirm a second straight year of steep increases, though a handful of states used their own regulatory authority to soften the impact considerably. This matters…
KFF released a 10-question quiz in March 2026 testing basic health insurance concepts like premiums, deductibles, and health savings accounts. It’s a quick self-check, but it also points to a much bigger and well-documented problem: most Americans struggle to understand the coverage they’re paying for every month. That confusion isn’t just academic. It shows up…
Open Enrollment for 2027 Marketplace coverage starts November 1, and this year’s shopping season looks meaningfully different from last year’s. It’s the second consecutive year without the enhanced premium tax credits that used to cap costs for higher earners, insurers are proposing another round of double-digit rate increases, and several carriers are leaving the market…
Health care affordability is not an abstract policy debate for most people. It is a monthly math problem that is getting harder to solve. A KFF data note updated April 30, 2026, titled Americans’ Challenges with Health Care Costs, pulls together KFF’s recent polling to show just how widespread that struggle has become, from skipped…
Starting January 1, 2027, most adults ages 19 to 64 who receive Medicaid through the ACA expansion must document at least 80 hours per month of qualifying community engagement activities, including work, education, job training, or volunteer service, or lose their coverage. The exemption most people are asking about, medical frailty, is narrower than almost…
The ACA coverage gap describes millions of Americans who earn too little to qualify for subsidized Marketplace coverage but live in states that have not expanded Medicaid to cover them, leaving them without a realistic path to affordable health insurance through either system. This gap exists not because of anything about the people in it,…
COBRA continuation coverage costs so much because you are now paying the full employer-sponsored premium yourself, a premium your employer previously paid 84% of for single coverage and 74% of for family coverage, plus a 2% administrative fee on top, which in 2025 adds up to an average of $793 a month for an individual…
Crossing the ACA subsidy cliff by even one dollar in 2026 eliminates your entire premium tax credit immediately, with no gradual phase-out, and depending on your household size and age, that single dollar of extra income can cost you anywhere from $4,000 to more than $22,000 in lost annual assistance. This post exists because the…
On-exchange and off-exchange ACA plans are both fully ACA-compliant and cover the same ten essential health benefits, but they are not always the same plan at the same price, and in 2026, a market pricing quirk called silver loading means that a Silver plan bought off-exchange can actually cost less than the identical plan bought…
Starting with 2026 Marketplace coverage, anyone who receives more advance premium tax credit than they actually qualify for must repay the full excess amount when they file their taxes in 2027, because the federal repayment caps that previously limited how much lower- and middle-income enrollees had to pay back have been permanently eliminated. This is…