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.

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Consumer Assistance in Health Insurance: Evidence of Impact and Unmet Need

The Affordable Care Act (ACA) established in-person consumer assistance programs to help people identify coverage options and enroll. A variety of professionals provide consumer assistance, including Navigator programs that are funded through state and federal marketplaces, brokers who receive commissions from insurers, local non-profit organizations, and health care providers. In the spring of 2020, KFF surveyed consumers most likely to use or benefit from consumer assistance to learn who uses consumer assistance, why they seek help, and what difference it makes as well as who does not get help and why.

KFF Health Tracking Poll: The Public’s Views on the ACA

This interactive chart allows users to track public opinion on the Affordable Care Act, from the inception of the law to the present, for subgroups based on age, race, income, gender, party identification and insurance status.

An Early Look at 2021 Premium Changes on ACA Exchanges and the Impact of COVID-19 on Rates

A look at preliminary marketplace rate filings reveals many premium changes for 2021 are moderate thus far, with increases or decreases of a few percentage points. However, most insurers have not yet incorporated the rate impacts of the COVID-19 pandemic in their rate changes for 2021, so many of these proposed rates are likely to change.

Individual Insurance Market Performance in Early 2020

Individual market insurers, on average, remained profitable through the first three months of 2020 as claims costs rose only slightly compared to the same period last year. It is likely that the most significant impacts of the coronavirus on the individual market will not be evident nationally until second or third quarter data are released.

How Many Uninsured Adults Could Be Reached If All States Expanded Medicaid?

As more people lose their jobs and accompanying ESI, more may fall into the coverage gap, particularly starting in 2021 after unemployment benefits expire for many who have lost their jobs and incomes are likely to drop below the minimum threshold for marketplace subsidies. This analysis estimates how many uninsured adults—including those uninsured even before the pandemic and those who could become uninsured as a result of it— could become eligible for Medicaid if states that have not yet expanded the program do so.