More than a decade after its enactment, tens of millions of people nationwide rely on coverage options created through the Affordable Care Act of 2010 (ACA). The law has survived multiple court challeges at the U.S. Supreme Court and repeated attempts by Republicans in Congress to repeal it. Subsequent legislation has scaled back some aspects of the law and expanded others, including by the COVID-19 relief bill, the American Response Plan Act of 2021. This page highlights relevant analysis about the ACA and proposed and enacted changes to it..
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

Potential Costs and Impact of Health Provisions in the Build Back Better Act
A summary of 10 of the major health coverage and financing provisions of the current Build Back Better Act, with discussion of the potential implications for people and the federal budget.
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Related Affordable Care Act Resources
- 5 Charts About Public Opinion on the Affordable Care Act
- A Closer Look at the Uninsured Marketplace Eligible Population Following the American Rescue Plan Act
- Eligibility for ACA Health Coverage Following Job Loss
- Pre-Existing Condition Prevalence for Individuals and Families
- Building on the Evidence Base: Studies on the Effects of Medicaid Expansion, February 2020 to March 2021
- FAQs: Health Insurance Marketplace and the ACA
- Explaining Health Care Reform: Questions About Health Insurance Subsidies
- Status of State Medicaid Expansion Decisions: Interactive Map
- Preventive Services Tracker
- Tracking Section 1332 State Innovation Waivers

How Marketplace Costs and Premiums will Change if Rescue Plan Subsidies Expire
In this Policy Watch we explore the potential impact of the expiration of the American Rescue Plan Act’s enhanced financial help and new eligibility for the Affordable Care Act’s health insurance Marketplace federal subsidies. While the COVID-19 relief legislation passed earlier this year provides greater subsidy assistance through 2022, Democrats in Congress are currently considering making the temporary federal help permanent or extending it as part of their planned budget reconciliation legislation.
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How Will the Uninsured in Colorado Fare Under the Affordable Care Act?
This state report explains how the ACA expands coverage in Colorado, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Colorado are eligible for Medicaid or financial assistance in the Marketplace. For states not expanding Medicaid, the report quantifies how many uninsured people fall into the “coverage gap,” meaning they will be ineligible for financial assistance in the Marketplace or for Medicaid in their state despite having an income below the federal poverty level.
Fact Sheet Read MoreHow Will the Uninsured in Iowa Fare Under the Affordable Care Act?
This state report explains how the ACA expands coverage in Iowa, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Iowa are eligible for Medicaid or financial assistance in the Marketplace. For states not expanding Medicaid, the report quantifies how many uninsured people fall into the “coverage gap,” meaning they will be ineligible for financial assistance in the Marketplace or for Medicaid in their state despite having an income below the federal poverty level.
Fact Sheet Read MoreHow Will the Uninsured in Louisiana Fare Under the Affordable Care Act?
This state report explains how the ACA expands coverage in Louisiana, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Louisiana are eligible for Medicaid or financial assistance in the Marketplace. For states not expanding Medicaid, the report quantifies how many uninsured people fall into the “coverage gap,” meaning they will be ineligible for financial assistance in the Marketplace or for Medicaid in their state despite having an income below the federal poverty level.
Fact Sheet Read MoreHow Will the Uninsured in Maine Fare Under the Affordable Care Act?
This state report explains how the ACA expands coverage in Maine, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Maine are eligible for Medicaid or financial assistance in the Marketplace. For states not expanding Medicaid, the report quantifies how many uninsured people fall into the “coverage gap,” meaning they will be ineligible for financial assistance in the Marketplace or for Medicaid in their state despite having an income below the federal poverty level.
Fact Sheet Read MoreHow Will the Uninsured in Tennessee Fare Under the Affordable Care Act?
This state report explains how the ACA expands coverage in Tennessee, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Tennessee are eligible for Medicaid or financial assistance in the Marketplace. For states not expanding Medicaid, the report quantifies how many uninsured people fall into the “coverage gap,” meaning they will be ineligible for financial assistance in the Marketplace or for Medicaid in their state despite having an income below the federal poverty level.
Fact Sheet Read MoreHow Will the Uninsured in West Virginia Fare Under the Affordable Care Act?
This state report explains how the ACA expands coverage in West Virginia, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in West Virginia are eligible for Medicaid or financial assistance in the Marketplace. For states not expanding Medicaid, the report quantifies how many uninsured people fall into the “coverage gap,” meaning they will be ineligible for financial assistance in the Marketplace or for Medicaid in their state despite having an income below the federal poverty level.
Fact Sheet Read MoreHealth Insurance Coverage in 2013: Gains in Public Coverage Continue to Offset Loss of Private Insurance
The recession accelerated the long-standing decline in employer-sponsored health insurance and through 2013 most of the recovery in the uninsured rate was due to increased enrollment in public insurance, primarily Medicaid and the Children’s Health Insurance Program (CHIP). With the exception of young adults ages 19 to 25, who are able to remain on their parents’ health plan until age 26 under the ACA, ESI coverage rates for adults and children continued to decrease between 2010 and 2013.
Issue Brief Read MoreAt Tax Time, No Public Backlash Over Obamacare’s Individual Mandate
This was published as a Wall Street Journal Think Tank column on April 21, 2015. Tax season has come and gone with no great outbreak of protest about the Affordable Care Act’s least popular provision: the individual mandate. This central element of the ACA was included to help ensure that the individual…
Perspective Read MoreAccess to Care for the Insured and Remaining Uninsured: A Look at California During Year One of ACA Implementation
California is a bellwether state for understanding the impact of the Affordable Care Act (ACA). Much attention has been paid to enrollment in California’s new coverage options, such as the Medicaid expansion (Medi-Cal) and plans sold through ACA marketplaces (Covered California), and to changes in the uninsured from 2013 to 2014. However, less is known about how this coverage has affected people’s access to care and financial security, and why others remain uninsured. This report, based on the 2014 Kaiser Survey of Low-Income Americans aims to fill this gap by comparing the newly insured, previously insured and remaining uninsured across several of these important dimensions.
Issue Brief Read MoreAfter King v. Burwell Ruling, Health Law Issues Involve Implementation
With the Supreme Court ruling on King v. Burwell upholding the Affordable Care Act’s federal subsidies, Drew Altman’s column in The Wall Street Journal’s Think Tank explores what the decision means and what’s next for the health law.
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