Marketplace enrollees largely see health insurance as very important to their ability to access care, to their financial well-being, and to their peace of mind; however, if the enhanced premium tax credits are not extended, many of the twenty-four million adults in the U.S. who currently buy their own insurance through the ACA Marketplace may consider changes to their current coverage. When asked what they would do if the amount they pay for health insurance each month doubled, one in three enrollees (32%) say they are very likely to shop for a lower-premium plan (with higher deductibles and out-of-pocket costs) and one in four (25%) say they would be very likely to go uninsured.

About 22 million of the 24 million Marketplace enrollees have benefited from the expiring tax credits, and without them, their premium payments are expected to rise an average of 114%, from $888 to $1,904 annually.

This KFF 2025 Marketplace Enrollees Survey was designed and analyzed by public opinion researchers at KFF. The survey was conducted November 7-15, 2025, online and by telephone among a nationally representative sample of 1,350 U.S. adults ages 18-64 who are covered by a plan purchased through the Affordable Care Act Marketplace, in English (n=1,301) and in Spanish (n=49). The sample includes 972 adults (n=24 in Spanish) reached through the SSRS Opinion Panel either online (n=944) or over the phone (n=28).

The SSRS Opinion Panel is a nationally representative probability-based panel where panel members are recruited randomly in one of two ways: (a) Through invitations mailed to respondents randomly sampled from an Address-Based Sample (ABS) provided by Marketing Systems Groups (MSG) through the U.S. Postal Service’s Computerized Delivery Sequence (CDS); (b) from a dual-frame random digit dial (RDD) sample provided by MSG. For the online panel component, invitations were sent to panel members by email followed by up to three reminder emails.