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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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.Issue Brief Read More
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.Issue Brief Read More
This brief explains how the new regulations issued by the Trump Administration would change the contraceptive coverage requirement for employers and affect women’s coverage, the legal positions for challenging and defending these regulations, the potential rulings, and the broader ramifications.Issue Brief Read More
The Uninsured and the ACA: A Primer – Key Facts about Health Insurance and the Uninsured amidst Changes to the Affordable Care Act
The Uninsured and the ACA: A Primer provides information on how insurance has changed under the ACA and more recent policy changes, how many people remain uninsured, who they are, and why they lack health coverage. It also summarizes what we know about the impact that a lack of insurance can have on the health outcomes and personal finances and the difference health insurance can make in people’s lives.Report Read More
In this May 2020 post for The JAMA Health Forum, Larry Levitt explores how the massive and rapid job losses of the past few months will test the ACA’s coverage safety net – and how different policies could strengthen or weaken it.Perspective Read More
Encuentre respuestas a las preguntas más comunes sobre seguros médicos incluyendo: Obamacare; el mercado de seguros; ayuda para pagar las primas de los seguros de salud; salud de las mujeres y de los inmigrantes.FAQ Read More
In his Axios column, Drew Altman shows how threatening the Affordable Care Act in the U.S. Supreme Court, or overturning it, could hurt President Trump with independent voters, and says that could matter most in battleground states.Perspective Read More
Amid the Coronavirus Crisis, President Trump and Democratic Nominee Joe Biden Offer Widely Different Views on Health Care
President Trump and Democratic nominee Joe Biden hold widely divergent views on health issues, with the president’s record and response to the coronavirus pandemic likely to play a central role in November’s elections. A new KFF side-by-side comparison examines President Trump’s record and former Vice President Biden’s positions across a…News Release Read More
The Affordable Care Act (ACA) requires new private health insurance plans to cover many recommended preventive services without any patient cost-sharing. This tracker presents up-to-date information on the adult preventive services nongrandfathered private plans must cover, by condition, including a summary of the recommendation, the target population, the effective date of coverage, and related federal coverage clarifications.Report Read More
The Status and Likely Impact of Final Regulations on Payments for Abortion Coverage in ACA Marketplace Plans
This brief summarizes the status and implications of the Trump Administration final regulations, published in December 2019, that change how ACA Marketplace plans that include coverage for abortion must bill and consumers must pay premiums for that coverage.Issue Brief Read More