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. The Trump Administration’s actions and decisions also have affected the ACA marketplaces and will continue to reshape how Americans get health insurance into 2019 and beyond.

For information about ACA Marketplace Open Enrollment, including fact sheets and 300+ FAQs, visit our collection of resources on Understanding Health Insurance.

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The Effects of Medicaid Expansion under the ACA: Updated Findings from a Literature Review

This issue brief summarizes findings from 324 studies of the impact of state Medicaid expansions under the ACA published between January 2014 (when the coverage provisions of the ACA went into effect) and June 2019. It includes studies, analyses, and reports published by government, research, and policy organizations using data from 2014 or later. This body of research suggests that the expansion presents an opportunity for gains in coverage, improvements in access and financial security, and economic benefits for states and providers.

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KFF Health Tracking Poll – July 2019: The Future of the ACA and Possible Changes to the Current System, Preview of Priorities Heading Into 2nd Democratic Debate

This month’s KFF Health Tracking Poll explores public opinion towards a government-administered public option, and finds that attitudes can change after hearing common arguments. The poll also examines the public’s views toward Medicare-for-all and the Affordable Care Act, as well as the top issues for Democrats ahead of the second round of presidential debates.

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Poll: Strong Initial Support for a Public Option, But Arguments Can Significantly Shift Views

Health Care Remains a Top Issue for Democrats Heading into Next Debates; At This Stage, More Want to Hear About Candidates’ Difference than Contrasts with President Trump The 2020 presidential election may be shaping up to be another election cycle focused on health care, with Democratic candidates offering competing proposals…

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The Henry J. Kaiser Family Foundation

Analysis: ‘Cadillac Tax’ on High-Cost Health Plans Could Affect 1 in 5 Employers in 2022

A new KFF analysis estimates that the Affordable Care Act’s tax on high-cost health plans would affect one in five (21%) employers offering health benefits when it takes effect in 2022 unless employers change their health plans. An even larger share (31%) could be affected when workers’ voluntary contributions to…

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How Many Employers Could Be Affected by the High-Cost Plan Tax

The high cost plan tax (HCPT) sometimes referred to as the Cadillac tax, is an excise tax on the cost of employer health benefit exceeding certain threshold. The HCPT provides a powerful incentive to control health plans costs over time, whether through efficiency gains or shifts in costs to workers. While many employers do not expect that the tax will take effect in 2022, others are already amending their health programs in anticipation. We estimate if the tax takes effect in 2022, 21% will be subject to the tax, increasing to 37% by 2030 unless firms reduce costs. Larger shares would be affected when counting workers’ voluntary contributions to Flexible Spending Accounts (FSAs)

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The Henry J. Kaiser Family Foundation

Explaining Texas v. U.S.: A Guide to the 5th Circuit Appeal in the Lawsuit Challenging the Affordable Care Act 

The outcome of the Texas v. U.S. legal challenge to the Affordable Care Act (ACA) could have far-reaching consequences for the nation’s health system, from rolling back the expansion of Medicaid to removing protections for people with pre-existing conditions and revoking the ability of adult children to stay on their…

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Explaining Texas v. U.S.: A Guide to the 5th Circuit Appeal in the Case Challenging the ACA

This issue brief answers key questions about Texas v. U.S., the case challenging the Affordable Care Act, leading up to the oral argument on appeal.

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Brief Examines Proposed Changes to Federal Anti-Discrimination Protections in Health Care that Would Limit Protections related to Gender Identity, Access to Abortion and Language Access

A new brief analyzes the Trump Administration’s proposed changes to federal anti-discrimination regulations that would eliminate existing protections in health care related to gender identity and access to abortion, and narrow protections for non-English speakers.

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HHS’s Proposed Changes to Non-Discrimination Regulations Under ACA Section 1557

Section 1557 of the Affordable Care Act prohibits discrimination based on race, color, national origin, sex, age, and disability in health programs and activities receiving federal funds. Here are the significant ways HHS’s proposed rule would narrow the scope of this regulation.

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Key State Policy Choices About Medical Frailty Determinations for Medicaid Expansion Adults

This issue brief answers 3 key questions and provides new data about state medical frailty determinations, which are assuming greater importance as more states adopt restrictive Section 1115 waivers that exempt medically frail enrollees from policies such as work requirements and premiums. The findings are excerpted from our 50-state survey on Medicaid financial eligibility for seniors and people with disabilities.

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