{"id":284792,"date":"2026-01-22T10:55:11","date_gmt":"2026-01-22T15:55:11","guid":{"rendered":"https:\/\/alpha.pewresearch.org\/pewresearch-org\/?post_type=short-read&p=284792"},"modified":"2026-01-22T15:11:39","modified_gmt":"2026-01-22T20:11:39","slug":"what-the-data-says-about-affordable-care-act-health-insurance-exchanges","status":"publish","type":"short-read","link":"https:\/\/alpha.pewresearch.org\/pewresearch-org\/short-reads\/2026\/01\/22\/what-the-data-says-about-affordable-care-act-health-insurance-exchanges\/","title":{"rendered":"What the data says about Affordable Care Act health insurance exchanges"},"content":{"rendered":"\n

Nearly 23 million Americans get health insurance through one of the online \u201cexchanges\u201d (also called \u201cmarketplaces\u201d) that operate under the 2010 Affordable Care Act<\/a>, or ACA. Most receive subsidies from the federal government to lower their premiums and out-of-pocket costs.<\/p>\n\n\n\n

In 2021, Congress enhanced the law\u2019s original subsidies and extended them to more people. But those changes expired at the end of 2025, meaning that millions of people now face higher insurance costs. The nonpartisan Congressional Budget Office estimates that 4.2 million more people<\/a> will be uninsured by 2034 as a direct result of Congress not extending the enhanced subsidies.<\/p>\n\n\n\n

The ACA made many changes to the U.S. health care system, from expanding Medicaid eligibility<\/a> to prohibiting insurers from denying coverage based on preexisting conditions. But in many ways, the exchanges are the heart of the law. Here are answers to some common questions about the exchanges and how they work.<\/p>\n\n\n\n