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
Affordability in the ACA Marketplace Under a Proposal Like Joe Biden’s Health Plan
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
Potential Impact of California v. Texas Decision on Key Provisions of the Affordable Care Act
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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The Effects of Medicaid Expansion under the ACA: Updated Findings from a Literature Review
This issue brief summarizes findings from 404 studies of the impact of state Medicaid expansions under the ACA published between January 2014 (when the coverage provisions of the ACA went into effect) and January 2020. It includes studies, analyses, and reports published by government, research, and policy organizations using data from 2014 or later. This body of research suggests that the expansion presents an opportunity for gains in coverage, improvements in access and financial security, and economic benefits for states and providers.
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Changes in Health Coverage by Race and Ethnicity since the ACA, 2010-2018
People of color historically have been more likely to be uninsured and to face more barriers accessing care than Whites. The Affordable Care Act (ACA) health coverage expansions provided an opportunity to help reduce these disparities. This brief examines changes in health coverage since the implementation of the ACA by race and ethnicity and discusses the implications for health coverage disparities.
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Disparities in Health and Health Care: Five Key Questions and Answers
This brief provides an introductory overview of health and health care disparities, including what disparities are and why they matter, the status of disparities today, and key efforts to address disparities, including provisions in the Affordable Care Act (ACA) and their impact on health and health care disparities.
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POSTPONED – The ACA at 10: What We’ve Learned from the States and How the 2020 Elections Could Shape the Future
THIS EVENT HAS BEEN POSTPONED. This planned March 18 public forum organized by the Kaiser Family Foundation and the National Academy for State Health Policy public forum has been postponed. Additional information will be posted as it becomes available. The event would have featured two panel discussions examining the Affordable…
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Republican Voters Have Moved On from Hating the ACA
In this Axios column, Drew Altman analyzes KFF’s tracking poll and shows that the ACA is now yesterday’s issue for Republicans. They have shifted their sights to Medicare-for-all…at least for this election season.
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KFF Health Tracking Poll – February 2020: Health Care in the 2020 Election
This month’s KFF Health Tracking poll explores the role of health care in the 2020 election, and public opinion on the Affordable Care Act.
Poll Finding Read MorePoll: Nearly 10 Years after Its Enactment, the Affordable Care Act is More Popular Than Ever as Republican Voters Instead Target Medicare-for-All
ACA is more popular than ever as Republican voters instead target Medicare-for-all; swing voters prefer a public option to Medicare-for-all.
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The Past, Present, And Possible Future Of Public Opinion On The Affordable Care Act
This Health Affairs article reviews 102 nationally representative public opinion polls in the period 2010–19 and finds public opinion has shifted in a sustained way at only two points in time: in a negative direction following technical problems in the first enrollment period, and in a positive direction after President Donald Trump’s election and subsequent Republican repeal efforts.
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Sexually Transmitted Infections (STIs): An Overview, Payment, and Coverage
More people have health insurance than ever before under the Affordable Care Act (ACA), which emphasizes preventive care, including no-cost HIV and STI counseling and screening for recommended populations. This fact sheet examines trends and disparities in STI prevalence, reviews the STI screening and preventive care coverage policies for private insurance and public programs, and discusses coverage gaps and confidentiality concerns in the provision of these services.
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Health Issues and the Election Quiz
Test your knowledge about health facts, policy issues and proposals that are emerging among the 2020 presidential candidates. The 10 questions focus on health issues in the 2020 election, including: health care costs, prescription drug prices, the Affordable Care Act and changes in health insurance coverage, reproductive health, and Medicare-for-all and public option proposals.
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