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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Medicaid Expansion through Premium Assistance: Key Issues for Beneficiaries in Arkansas’ Section 1115 Demonstration Waiver Proposal
This issue brief provides background about Medicaid premium assistance in the individual health insurance market, summarizes major components of Arkansas’ Section 1115 demonstration waiver application to implement the Affordable Care Act’s Medicaid expansion through premium assistance, and considers key issues affecting beneficiaries.Issue Brief Read More
As states wrap up legislative sessions and make decisions about whether to implement the Medicaid expansion included in the Affordable Care Act (ACA), this new analysis highlights the implications of these decisions for coverage, state budgets and providers. The decisions by as many as 27 states not to adopt the Medicaid expansion will leave a many more uninsured; these states would also forgo billions in federal funds.Report Read More
Transitioning Beneficiaries with Complex Care Needs to Medicaid Managed Care: Insights from California
This brief examines how health service providers, plan administrators, and community-based organizations in Contra Costa, Kern, and Los Angeles Counties experienced the transition of Medi-Cal-only seniors and persons with disabilities (SPDs) to managed care as part of the state’s “Bridge to Reform” Medicaid waiver. Findings presented may inform similar transitions of high-need beneficiaries in other states and coverage expansions in 2014 under the Affordable Care Act.Issue Brief Read More
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.Issue Brief Read More
As the country gears up for implementation of the major provisions of the Affordable Care Act (ACA), June’s Kaiser Health Tracking Poll takes a step back and examines views on health insurance more broadly among some key subgroups, including young adults, the uninsured, and those with pre-existing conditions. The poll finds that the large majority of Americans want and value health insurance.Poll Finding Read More
This Policy Insight explores possible explanations for the continued rise in Medicare Advantage enrollment between 2010 and 2013 in spite of a projected decrease following payment changes in the Affordable Care Act (ACA).Perspective Read More
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.Issue Brief Read More
The Medical Loss Ratio (MLR) provision of the Affordable Care Act (ACA) saved consumers an estimated $2.1 billion last year, in the form of lower premiums and rebates, according to a new analysis by the Kaiser Family Foundation. Under health reform, insurers must issue consumer rebates if they fail to spend a certain portion of premium income on health care claims and quality improvement expenses, thereby limiting what they may spend on administrative expenses or keep as profits.Perspective Read More
The Affordable Care Act (ACA) will significantly increase coverage options through an expansion of Medicaid and the creation of new health insurance exchange marketplaces. However, effective outreach and enrollment efforts will be key to ensuring that new coverage opportunities translate into increased coverage. Based on a review of existing research,…Issue Brief Read More
This Pulling It Together was adapted from a column I published earlier this week in Politico, with a new introduction added. You can read the original Politico column here. The implementation of the ACA is news and the public will demand information about it. Journalists and news organizations have an obligation…Perspective Read More