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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Kaiser Health Tracking Poll: December 2013

The December Kaiser Health Tracking Poll finds a 13 percentage point rebound in Democratic support for the Affordable Care Act (ACA), but no overall change in support or opposition since November. In spite of all the attention and controversy surrounding the law and its implementation, the poll finds that nearly half of the public say it won’t make much difference to them or their families.

Obamacare Vital Signs Not Just Numbers

In his latest column, Kaiser President and CEO Drew Altman discusses the focus on first year metrics, especially enrollment projections, in the ACA debate.

Premium 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…

California’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.

Quantifying Tax Credits for People Now Buying Insurance on Their Own

This analysis estimates that Americans currently buying insurance on the individual market would receive $2700 in subsidies (as tax credits) in 2014 under Obamacare. Tax credits are available for qualifying people buying insurance through the new health care marketplaces, or exchanges.

Quality of Care in Community Health Centers and Factors Associated with Performance

This study examines quality among health centers relative to Medicaid managed care organizations (MCOs). Chronic care quality among health centers is high; gaps in women’s preventive care are a concern. Lower-performing health centers have very high uninsured and homeless rates. The expansion of Medicaid and private insurance under the ACA may foster gains in health center quality performance.

The Affordable Care Act and Insurance Coverage in Rural Areas

Rural populations face disparities compared to metropolitan populations in health care. While rural individuals were not more likely to be uninsured than metropolitan counterparts pre-Affordable Care Act, they were poorer and less likely to have private insurance. With coverage changes in the ACA involving an expansion of Medicaid for poor and near-poor populations, decisions by states with large rural populations may cause rural residents to have disparate access to coverage, which may exacerbate cost and access barriers to health care.