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.

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Kaiser Health Tracking Poll: October 2014

In the final Kaiser Health Tracking Poll before the 2014 midterm elections in November, the Affordable Care Act (ACA) continues to be just one of several issues on voters’ minds. Less than 1 in 10 registered voters identify the ACA as the most important issue to their vote, ranking behind the economy, dissatisfaction with government, education and the situation in Iraq and Syria. With the ACA’s second open enrollment period approaching, the poll also finds the uninsured are not yet tuned in. About 9 in 10 of the uninsured are unaware of when the next open enrollment period begins, two thirds say they know “only a little” or “nothing at all” about the marketplaces, and just over half are unaware of financial assistance available.

The ACA Marketplace Problems in Context (and Why They Don’t Mean Obamacare Is ‘Failing’)

In this Wall Street Journal Think Tank column, Drew Altman discusses the latest challenges faced by the Affordable Care Act (ACA) marketplaces and why they should be kept in perspective: “If Obamacare had bipartisan support, they would be treated much more like mundane implementation issues to be addressed by Congress than glaring headlines about Obamacare failure.”

Analysis of UnitedHealth Group’s Premiums and Participation in ACA Marketplaces

This analysis looks at how a potential withdrawal by UnitedHealth Group from the Affordable Care Act (ACA) marketplaces in 2017 could impact insurer competition and premiums, finding a significant impact in some markets, though it would have a minimal effect on the average benchmark premium nationwide, The impacts of a UnitedHealth withdrawal would vary considerably by state and market area, with a more pronounced effect in rural areas. Since UnitedHealth often is not one of the lower cost plans, the effect nationally on premiums of an exit by the insurer would be modest.

JAMA Forum: Reports of Obamacare’s Demise Are Greatly Exaggerated

In this post for The JAMA Forum, the Kaiser Family Foundation’s Larry Levitt discusses UnitedHealth’s exit from Affordable Care Act marketplaces, the possibility of bigger premium increases in 2017, and why these challenges are unlikely to significantly affect long-term sustainability of the market and the law.

ACA Coverage and the Changing Labor Market: Voices from the Field

This brief highlights voices from adult focus group participants with low and moderate incomes who gained Medicaid or Marketplace coverage following implementation of the ACA. It focuses on work, including work status, the new labor market, job benefits, and the role of ACA coverage for those with non-traditional jobs.

What to Look for in 2017 ACA Marketplace Premium Changes

This brief discusses the key factors that will influence the rate changes that insurers are requesting in 2017 Affordable Care Act (ACA) Marketplaces, including current premiums, forecasted enrollment changes, increases in price and use of services, changes in policy design or network, changes in law or regulation, and competition.

Restructuring Medicaid in the American Health Care Act: Five Key Considerations

On March 9, the House Ways and Means Committee and Energy and Commerce Committee passed the American Health Care Act, the Republican leadership’s plan to repeal and replace the ACA. The Congressional Budget Office estimates that the House bill would reduce federal Medicaid spending by $880 billion over ten years by capping federal Medicaid spending and ending enhanced federal funding for Medicaid expansion adults. By 2026, federal Medicaid spending would be 25% lower than expected under current law, and 14 million fewer people would be covered by Medicaid than expected under current law. This brief considers five key Medicaid implications of the House bill.

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California.