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

Jan 3, 2020

Potential Impact of Texas v. U.S. Decision on Key Provisions of the Affordable Care Act

On December 14, 2018, a federal trial court judge ruled that the Affordable Care Act’s (ACA) individual mandate is unconstitutional and that the entire law should be struck down as a result. This brief considers the complex and far-reaching impact were the entire law ultimately held to be invalid.

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Related Affordable Care Act Resources

May 13, 2020

Eligibility for ACA Health Coverage Following Job Loss

As unemployment claims skyrocket amid the coronavirus (COVID-19) crisis, this analysis examines the potential loss of job-based coverage among people in families where someone lost employment between March 1 and May 2 and estimate their eligibility for ACA coverage as of May and January 2021, when most will have exhausted their unemployment benefits.

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January 6, 2015 Issue Brief

Analysis of 2015 Premium Changes in the Affordable Care Act’s Health Insurance Marketplaces

This analysis provides an early look at premium changes for individuals in the health insurance marketplaces, created under the Affordable Care Act (ACA), in major cities across 15 states plus DC. Although premium changes vary across and within states, premium changes for 2015 in general are modest when looking at low-cost plans. On average, individuals will pay slightly less in premiums for the benchmark silver plan in 2015 than in 2014.

September 9, 2014 Poll Finding

Kaiser Health Tracking Poll: August-September 2014

The latest Kaiser Health Tracking Poll includes a special look at registered voters’ views and what role, if any, the the Affordable Care Act might be playing in the upcoming midterm election. Partisan divisions on the law are as deep as ever, not only when it comes to overall opinion but also in the public’s perception of how the law has impacted their own families and the next steps they want Congress to take.

June 17, 2015 Poll Finding

Data Note: Predictors Of Positive And Negative Attitudes Towards The ACA Among Non-Group Insurance Enrollees

One of the groups perhaps most affected by changes brought about by the Affordable Care Act (ACA) are people who purchase their own health insurance in the non-group market. In this Data Note, we examine data from the Kaiser Family Foundation Wave 2 Survey of Non-Group Health Insurance Enrollees to explore the characteristics of non-group enrollees that are associated with positive and negative attitudes towards the ACA, including feeling personally benefited or negatively affected by the law.

June 19, 2015 Issue Brief

How Does Gaining Coverage Affect People’s Lives? Access, Utilization, and Financial Security among Newly Insured Adults

Using findings from the 2014 Kaiser Survey of Low-Income Americans and the ACA, this report focuses on the low- and middle-income newly insured in 2014, comparing them to the previously insured and they uninsured. It examines the compositions of these groups, as well as their access to care, financial security, and opinions on their coverage.

December 7, 2016 Issue Brief

Private Insurance Coverage of Contraception

Insurance coverage of contraceptive services has been the focus of policy attention by state and federal policymakers, as well as in the courts, over the past two decades. This issue brief explains the rules for private insurance coverage of contraceptives at the federal and state level and discusses key issues regarding the provision and coverage of contraception by private insurance plans, including the impact of the Affordable Care Act (ACA).

May 3, 2018 Issue Brief

Health and Access to Care and Coverage for Lesbian, Gay, Bisexual, and Transgender (LGBT) Individuals in the U.S.

Lesbian, gay, bisexual, and transgender (LGBT) individuals often face challenges and barriers to accessing needed health services and, as a result, can experience worse health outcomes. These challenges can include stigma, discrimination, violence, and rejection by families and communities, as well as other barriers, such as inequality in the workplace and health insurance sectors, the provision of substandard care, and outright denial of care because of an individual’s sexual orientation or gender identity. This issue brief examines population characteristics of the LGBT community and the impacts of the Affordable Care Act (ACA), Supreme Court rulings and other policy changes related to same-sex marriage that can insurance coverage and access to health care services, and recent actions by the Trump Administration.

October 7, 2015 Issue Brief

Women’s Health Issues Journal: Medicaid and Women’s Health Coverage Two Years into the Affordable Care Act

As Medicaid marks its 50th year, the program has unquestionably become the mainstay of health coverage for low-income women in the nation. Since its inception, its role for women has continued to evolve and expand, but the passage of the Affordable Care Act (ACA) swung open the doors for Medicaid to serve even more low-income women who lack access to private or employer-based insurance. This is because the ACA enabled states to finally eliminate Medicaid’s historical “categorical” requirements, which had essentially shut out women and men without dependent children.

August 25, 2015 Perspective

Will GOP Candidates’ Positions on Obamacare Matter in Crowded Field?

In this column for The Wall Street Journal’s Think Tank, Drew Altman analyzes the politics of Republican Affordable Care Act replacement plans and the challenges all Republican candidates will face distinguishing themselves from others on the ACA in a crowded primary field.

May 20, 2015 Perspective

Are More Americans Benefiting From Obamacare Than Realize It?

In this column for The Wall Street Journal’s Think Tank, Drew Altman discusses why many people may not know whether or not they are benefiting from the Affordable Care Act.

June 3, 2015 Perspective

JAMA Forum: If King v Burwell Ruling Imperils ACA Subsidies for Millions, Is the Fallout Avoidable?

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.