President Donald Trump and Republicans in Congress pursued several major efforts to repeal and replace the Affordable Care Act (ACA) but were unable to get a bill through the U.S. Senate in 2017. In 2018, Congress did pass a tax bill that eliminated the ACA’s tax penalty for not obtaining health coverage beginning in 2019.
In December 2019, a federal appeals court panel ruled that the law’s individual mandate is unconstitutional since Congress has set the mandate tax penalty to zero and sent the case back to a lower court to determine how much of the rest of the ACA should be invalidated. The case was first brought by a number of Republican state attorneys general, and the Trump administration now argues that nearly all of the ACA should be overturned. The U.S. Supreme Court has now agreed to review the case.
For information about ACA Marketplace Open Enrollment, including fact sheets and 300+ FAQs, visit our collection of resources on Understanding Health Insurance.
Featured Affordable Care Act Resources
Affordability in the ACA Marketplace Under a Proposal Like Joe Biden’s Health Plan
This KFF analysis finds that expanding Affordable Care Act (ACA) premium subsidies like Democratic presidential nominee Joe Biden has proposed would lower the cost of Marketplace coverage for nearly all potential enrollees, including the uninsured and others currently priced out of the Marketplace. Biden’s plan would, however, increase federal spending, which we do not attempt to estimate here.
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Related Affordable Care Act Resources
- Is COVID-19 a Pre-Existing Condition? What Could Happen if the ACA is Overturned
- 5 Charts About Public Opinion on the Affordable Care Act and the Supreme Court
- Explaining California v. Texas: A Guide to the Case Challenging the ACA
- Eligibility for ACA Health Coverage Following Job Loss
- Republican Voters Have Moved On from Hating the ACA
- The Effects of Medicaid Expansion under the ACA: Updated Findings from a Literature Review
- FAQs: Health Insurance Marketplace and the ACA
- Status of State Medicaid Expansion Decisions: Interactive Map
- Insurer Participation on ACA Marketplaces, 2014-2020
- Pre-Existing Condition Prevalence for Individuals and Families
- Preventive Services Tracker
- Tracking Section 1332 State Innovation Waivers
Potential Impact of California v. Texas Decision on Key Provisions of the Affordable Care Act
The Supreme Court will review the constitutionality of the Affordable Care Act (ACA) this November in California v. Texas. This fact sheet summarizes the major provisions of the ACA, illustrating the breadth of its changes to the health care system. If all of most of the ACA is struck down, many of these provisions could be eliminated.
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Implementation of Affordable Care Act Provisions to Improve Nursing Home Transparency, Care Quality, and Abuse Prevention
The Affordable Care Act (ACA) is the first comprehensive legislation since the Nursing Home Reform Act, part of the Omnibus Budget Reconciliation Act of 1987 (OBRA ’87), to expand quality of care-related requirements for nursing homes that participate in Medicare and Medicaid and improve federal and state oversight and enforcement.…
Report Read MoreKey Facts on Health Coverage for Low-Income Immigrants Today and Under the Affordable Care Act
Beginning in 2014, the Affordable Care Act will expand Medicaid and create new health insurance exchanges that will significantly increase coverage options for citizens and lawfully present immigrants. This brief provides an overview of health coverage for immigrants today and their new coverage options under health reform. Fact Sheet (.pdf)
Fact Sheet Read MoreCoverage of Colonoscopies Under the Affordable Care Act’s Prevention Benefit
The Affordable Care Act (ACA) requires private health insurers to cover recommended preventive services such as colonoscopies without any patient cost-sharing. This report finds that confusion over whether colon cancer screenings are preventive care or treatment means patients sometimes receive unexpected bills for the procedure. The report examines cost-sharing practices for colorectal screenings through interviews with experts and officials in the medical and insurance industries.
This report was co-authored by The Kaiser Family Foundation, American Cancer Society, and National Colorectal Cancer Roundtable.
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Pulling it Together: How the ACA Can Help The Homeless
Estimates are that there are approximately 630,000 people who are homeless on any given night in the U.S. — about two-thirds in shelters and one-third on the street or without real shelter. Several million people are estimated to experience homelessness over the course of a year. About two-thirds are individuals and the…
Perspective Read MoreKFF Data Note: Americans’ Views on the Personal Impact of the ACA and the Supreme Court’s Decision
As the Supreme Court hears cases challenging the constitutionality of parts of the Affordable Care Act, a relatively small share of the public thinks the Supreme Court’s decision will have a lot of impact on their family (28 percent). At the same time, the public is divided as to whether…
Perspective Read MorePremium Assistance in Medicaid and CHIP: An Overview of Current Options and Implications of the Affordable Care Act
Premium assistance is the use of public funds through Medicaid or the Children’s Health Insurance Program (CHIP) to purchase private coverage. States have pursued premium assistance with varied objectives, including covering parents not otherwise eligible for public coverage and promoting the use of private coverage. Implementation of the Affordable Care…
Issue Brief Read MoreKaiser Survey Probes Health Insurance Brokers’ Views on Insurance Trends, ACA
A new nationally representative survey of 500 health insurance agents and brokers working in the individual and small group markets by the Kaiser Family Foundation explores their outlook on market trends and views on the Affordable Care Act (ACA). The survey finds that many agents are seeing steep increases in premiums…
Perspective Read MoreData Note: Americans’ Views on the Personal Impact of the ACA and the Supreme Court’s Decision
This Data Note draws from the March 2012 Kaiser Health Tracking Poll and examines people’s impressions of how the law and the Court case will affect them, focusing primarily on those groups that are in the position to receive the greatest benefits. For the most part, those that stand to…
Poll Finding Read MoreHow is the Affordable Care Act Leading to Changes in Medicaid Long-Term Services and Supports (LTSS) Today? State Adoption of Six LTSS Options
Under the Affordable Care Act (ACA), states are afforded a number of new and expanded opportunities, including enhanced federal financing, to improve access to and delivery of Medicaid long-term services and supports (LTSS). This policy brief provides an overview of six key Medicaid LTSS options created or enhanced by the…
Issue Brief Read MoreCalifornia’s Health Care Environment and Health Reform Efforts: June 2013 Update
This brief provides and update of the health care and health policy environment in California, discussing the budgetary environment, implementation of the state’s “Bridge to Reform” Medicaid waiver, and efforts to prepare for coverage expansions and new coverage options in 2014 under the Affordable Care Act.
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