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
On December 14, 2018, a federal trial court judge ruled that the Affordable Care Act’s (ACA) individual mandate is unconstitutional and that the entire law should be struck down as a result. This brief considers the complex and far-reaching impact were the entire law ultimately held to be invalid.
Fact Sheet See More
Related Affordable Care Act Resources
- Explaining Texas v. U.S.: A Guide to the Case Challenging the ACA
- Coronavirus Response and the Affordable Care Act
- Republican Voters Have Moved On from Hating the ACA
- FAQs: Health Insurance Marketplace and the ACA
- Status of State Medicaid Expansion Decisions: Interactive Map
- How ACA Marketplace Premiums Are Changing by County in 2020
- Insurer Participation on ACA Marketplaces, 2014-2020
- The Past, Present, And Possible Future Of Public Opinion On The Affordable Care Act
- Pre-Existing Condition Prevalence for Individuals and Families
- Preventive Services Tracker
This month’s KFF Health Tracking poll explores the role of health care in the 2020 election, and public opinion on the Affordable Care Act.
Poll Finding See More
- view as grid
- view as list
Pre-existing Conditions and Medical Underwriting in the Individual Insurance Market Prior to the ACA
This brief reviews medical underwriting practices by private insurers in the individual health insurance market prior to 2014, and estimates how many American adults could face difficulty obtaining private individual market insurance because of a pre-existing condition if the Affordable Care Act (also known as Obamacare) were repealed or amended and such practices resumed.Issue Brief Read More
Nearly 54 Million Americans Have Pre-Existing Conditions That Would Make Them Uninsurable in the Individual Market without the ACA
Almost Half of Non-Elderly Families have At Least One Adult with a Pre-Existing Condition An updated KFF analysis estimates that almost 54 million people – or 27% of all adults under 65 —have pre-existing health conditions that would likely have made them uninsurable in the individual markets that existed in…News Release Read More
Affordable Care Act Premiums Are Falling in Many Areas of the U.S. in 2020, But Changes Vary Widely By County and Type of Plan, County-Level Analysis Shows
Although premiums for Affordable Care Act Marketplace benchmark silver plans are decreasing on average across the U.S. in 2020, changes vary widely by geographic location and plan type, including premium increases in a number of counties and plans, according to a new KFF analysis of county-level data. The analysis of…News Release Read More
Since the Affordable Care Act (ACA) health insurance marketplaces opened in 2014, there have been a number of changes in insurance participation as companies entered and exited states and also changed their footprint within states. This brief and interactive maps show how insurance participation has changed over time in every county in the U.S.Issue Brief Read More
Two Medicaid-Related Initiatives That Help Promote Long-Term Care at Home and in the Community, Rather Than in Institutions, Are Set To Expire at the End of December
Two initiatives that for years have helped shift Medicaid enrollees away from nursing homes in favor of long-term care at home and in the community face year-end deadlines that could undercut that trend, according to two new KFF issue briefs. While there does not appear to be substantive disagreement over…News Release Read More
Intimate partner violence has been shown to be associated with increased risk for HIV among women, as well as poorer treatment outcomes for those already diagnosed. This brief reviews the link between IPV and HIV, key policy changes and initiatives that attempt to address these challenges.Issue Brief Read More
With a questionable outlook for 2020 passage of legislation on prescription drug pricing and surprise medical bills, Drew Altman says the real action to watch in health policy is likely to be in the states.Perspective Read More
In states that do not implement the Medicaid expansion under the Affordable Care Act (ACA), many adults will fall into a “coverage gap” of earning too much to qualify for Medicaid but not enough to qualify for Marketplace premium tax credits. Nationwide, 2.3 million poor uninsured adults are in this situation. This brief presents estimates of the number of people in non-expansion states who could have been reached by Medicaid but instead fall into the coverage gap and discusses the implications of them being left out of ACA coverage expansions.Issue Brief Read More
On December 14, 2018, a federal trial court judge ruled that the Affordable Care Act’s (ACA) individual mandate is unconstitutional and that the entire law should be struck down as a result. This brief considers the complex and far-reaching impact were the entire law ultimately held to be invalid.Fact Sheet Read More
This month’s poll probes Democrats’ views about the general approaches to expanding health coverage and lowering costs put forward by the candidates; the public’s health care priorities for Congress; and views about the ACA, Medicare-for-all and a “public option” health plan.Poll Finding Read More