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
This KFF analysis finds that expanding Affordable Care Act (ACA) premium subsidies like Democratic presidential nominee Joe Biden has proposed would lower the cost of Marketplace coverage for nearly all potential enrollees, including the uninsured and others currently priced out of the Marketplace. Biden’s plan would, however, increase federal spending, which we do not attempt to estimate here.
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Related Affordable Care Act Resources
- Is COVID-19 a Pre-Existing Condition? What Could Happen if the ACA is Overturned
- 5 Charts About Public Opinion on the Affordable Care Act and the Supreme Court
- Explaining California v. Texas: A Guide to the Case Challenging the ACA
- Eligibility for ACA Health Coverage Following Job Loss
- Republican Voters Have Moved On from Hating the ACA
- The Effects of Medicaid Expansion under the ACA: Updated Findings from a Literature Review
- FAQs: Health Insurance Marketplace and the ACA
- Status of State Medicaid Expansion Decisions: Interactive Map
- Insurer Participation on ACA Marketplaces, 2014-2020
- Pre-Existing Condition Prevalence for Individuals and Families
- Preventive Services Tracker
- Tracking Section 1332 State Innovation Waivers
The Supreme Court will review the constitutionality of the Affordable Care Act (ACA) this November in California v. Texas. This fact sheet summarizes the major provisions of the ACA, illustrating the breadth of its changes to the health care system. If all of most of the ACA is struck down, many of these provisions could be eliminated.
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Larry Levitt’s March 2015 post explores what could happen if the U.S. Supreme Court rules for the plaintiffs in the King v. Burwell case, the lawsuit that challenges the federal government’s authority to provide financial assistance to people who buy insurance in federally-operated marketplaces created by the Affordable Care Act.Perspective Read More
As the second round of open enrollment approaches, policy makers, journalists, insurers and enrollment groups may want to keep in mind what health insurance shoppers told us about their experiences during the first open enrollment period. This data note examines selected findings from two Kaiser Family Foundation surveys that shed light on how people navigated the new options and choices available under the ACA during last fall’s open enrollment, with the hope of helping to inform our understanding of individuals needs during this second open enrollment period.Poll Finding Read More
This brief highlights data from a survey of state Medicaid programs conducted by KCMU on coverage of preventive services recommended for non-elderly adults before the ACA was enacted.Issue Brief Read More
In this column for The Wall Street Journal’s Think Tank, Drew Altman explains how Republican control of Congress will likely bring challenges to the Affordable Care Act in two flavors.Perspective Read More
Following the Nov. 4 midterm elections, nearly half of Americans expect increased debate between the two parties over the Affordable Care Act. In comparison, 42 percent say the amount of debate will not change, and very few (5%) say it will decrease. Conducted just prior to the start of the ACA’s second open enrollment season, the poll also probes the views of people without health insurance, one of the key target groups for outreach and enrollment efforts. It finds the uninsured remain largely unaware of the renewed opportunity to purchase or enroll in health insurance through the marketplaces over the next few months.Poll Finding Read More
This brief and accompanying slides examine cost sharing – deductibles, copayments and coinsurance – in 2015 insurance plans sold on the Affordable Care Act’s (ACA) federally-facilitated marketplaces. The analysis looks at out-of-pocket limits, as well as cost sharing for hospital stays, physician visits, emergency room visits, and prescription drugs, for plans across the metal levels (platinum, gold, silver and bronze).Issue Brief Read More
Other than the big stories of Ferguson, Ebola and ISIS, the only other news which captured a majority of the public’s attention this month was President Obama’s executive order on immigration. Smaller, yet substantial, shares report closely following many health policy news stories this month. Over four in ten say they closely followed the lawsuit filed by House Republicans against President Obama over the implementation of the health care law and about a third say they followed a change in the official estimate for the number of people that enrolled in health insurance during the ACA’s first open enrollment period and the ACA’s second open enrollment period. The least closely followed health policy story of those asked about this month, was coverage of comments about the ACA made by MIT health economist, Jonathan GruberPoll Finding Read More
Round 2 on the Legal Challenges to Contraceptive Coverage: Are Nonprofits “Substantially Burdened” by the “Accommodation”?
The Affordable Care Act (ACA) requires most private health insurance plans to provide coverage for a broad range of preventive services including Food and Drug Administration (FDA) approved prescription contraceptives and services for women. Since the implementation of the ACA contraceptive coverage requirement in 2012, over 200 corporations have filed lawsuits claiming that including coverage for contraceptives or opting for an “accommodation” from the federal government violates their religious beliefs. This brief explains the legal issues raised by the nonprofit litigation and discusses the impact of the Hobby Lobby decision on the current litigation.Issue Brief Read More
In this column for The Wall Street Journal’s Think Tank, Drew Altman discusses whether the debate about the Iran deal may bring a respite for the Affordable Care Act from politics as usual, and how long it might last.Perspective Read More
This nationwide survey analysis of Marketplace consumer assistance programs and brokers examines the nature of Marketplace assistance during the second open enrollment period for 2015 coverage, and offers unique insights into how Affordable Care Act (ACA) implementation is progressing, what is changing, and what challenges remain. Building upon our Survey of Health Insurance Marketplace Assister Programs (2014), the analysis compares Assister Program capacity and experiences from the first open enrollment period to the next, and also includes the enrollment experience of brokers for the first time.Report Read More