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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Outreach and Enrollment Strategies for Reaching the Medicaid Eligible but Uninsured Population

This brief identifies a range of successful strategies to reach and enroll Medicaid- and CHIP-eligible individuals as well as options to facilitate renewals. It draws on a collection of previous work examining state enrollment experiences after implementation of the ACA. In sum, it shows that states that have achieved enrollment success have embraced an array of strategies and approaches that include promoting the expansion through strong leadership and collaboration, implementing broad marketing and outreach campaigns, establishing a coordinated and diverse network of assisters, developing effective eligibility and enrollment systems that coordinate with the Marketplace, and planning ahead to translate coverage gains into improved access to care.

2016 Survey of Health Insurance Marketplace Assister Programs and Brokers

In its third year, the survey tracks the experiences of assistance programs signing people up for Affordable Care Act coverage during open enrollment and, for consumers who qualify, during special enrollment periods. This year, for the second time, the survey includes health insurance brokers who helped people apply for non-group coverage in an ACA marketplace.

Understanding Medicaid Hospital Payments and the Impact of Recent Policy Changes

Medicaid payments to hospitals, which include base and supplemental payments, play an important role in hospital finances and can affect beneficiaries’ access to care.This brief provides an overview of Medicaid payments for hospitals and explores the implications of the ACA Medicaid expansion, including changes in uncompensated care, as well as payment policy changes on hospital finances.

Overview of Medicaid Per Capita Cap Proposals

The House Republican Plan (“A Better Way”) released on June 22, 2016, includes a proposal to convert federal Medicaid financing from an open-ended entitlement to a per capita allotment or a block grant (based on a state choice). This proposal is part of a larger package designed to replace the Affordable Care Act (ACA) and reduce federal spending for health care. Often tied to deficit reduction, proposals to convert Medicaid’s financing structure to a per capita cap or block grant have been proposed before. Such changes represent a fundamental change in the financing structure of the program with major implications for beneficiaries, providers, states and localities. Key things to understand about a per capita cap include the following: how a per capita cap works, key design challenges, and implications of a per capita cap.

Two Year Trends in Medicaid and CHIP Enrollment Data: Findings from the CMS Performance Indicator Project

This brief provides an overview of recent trends in Medicaid and CHIP enrollment as of January 2016, based on data from the Centers for Medicare and Medicaid Services (CMS) produced as part of its Performance Indicator Project. The project was designed to provide timely data on Medicaid and CHIP eligibility and enrollment that are intended to help strengthen data-driven program management and oversight efforts at both the national and state level. They also provide insight into Medicaid and CHIP eligibility and enrollment experiences as the ACA is implemented. This brief examines data as of January 2016 to be able to look at two full years of data post implementation of the major coverage provisions in the Affordable Care Act (ACA).

Kaiser Health Tracking Poll: June 2016

The June Kaiser Health Tracking Poll examines attitudes on the Affordable Care Act and provides an in-depth analysis of two of the biggest health policy stories of the month: the Zika virus outbreak and reports about the rising costs of ACA health insurance premiums.

JAMA Forum: The Partisan Divide on Health Care

In this post for JAMA, the Kaiser Family Foundation’s Larry Levitt outlines the health care platforms of the Republican and Democratic parties, noting their fundamentally different aims and differing ideas about, among other things, the Affordable Care Act (also known as Obamacare) and Medicare.

How ACA Marketplace Premiums Measure Up to Expectations

Premium increases in the health insurance marketplaces created under the Affordable Care Act (ACA) will likely be higher in 2017 than in recent years; however, the actual average benchmark premium in the ACA marketplaces in 2016 is below what the Congressional Budget Office projected for 2016 before the health law was passed. How actual marketplace premiums compare to what CBO expected in doing those budget projections is an important factor in determining whether the ACA continues to be on track to reducing the deficit.

The Affordable Care Act After Six Years

In this column for The Wall Street Journal’s Think Tank, Drew Altman examines the role of the Affordable Care Act in the health system on its sixth anniversary, and how the hot debate about the law may have created an exaggerated impression of the good and the bad it can do.

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