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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Medicaid Coverage of Pregnancy and Perinatal Benefits: Results from a State Survey

This report details findings from a state survey on perinatal benefits in place as of July 1, 2015 for women enrolled in fee-for-service Medicaid through different eligibility pathways, including traditional pre-ACA Medicaid pathways, expansion, and pregnancy-related eligibility for the following services: basic prenatal care, counseling and support services, delivery and postpartum care, and breastfeeding supports.

Using Medicaid to Wrap Around Private Insurance: Key Questions to Consider

This issue brief raises three key questions for consideration if using Medicaid to wrap around private coverage is going to be considered as an alternative to the ACA’s Medicaid expansion under the BCRA. We draw on existing information about state Medicaid premium assistance programs to date, the administrative complexity involved, and the financing implications of premium assistance programs.

Kaiser Health Tracking Poll – August 2017: The Politics of ACA Repeal and Replace Efforts

Following the U.S. Senate’s failed vote on the “skinny repeal”, the latest Kaiser Health Tracking Poll finds that the majority of the public say it is a “good thing” that the Senate did not pass the bill that would have repealed and replaced the ACA. A large share of Americans think President Trump and his administration should do what they can to make the current health care law work and a majority of the public want to see bipartisan efforts to improve the 2010 health care law. However, about half of Republicans and Trump supporters would like to see Republicans in Congress keep working on a plan to repeal the ACA, and most Republicans and Trump supporters endorse using hard-ball tactics to encourage Democrats to start negotiating with President Trump on a replacement plan. The majority of the public are also unaware that health insurance companies choosing not to sell insurance plans or charging higher premiums in certain marketplaces only affect those who purchase their own insurance on these marketplaces.

Data Note: Strongly Held Views on the ACA

Since the passage of the Affordable Care Act in 2010, Kaiser Family Foundation polling has found the public divided in their overall views of the law. At the same time, an intensity gap in opinion has existed since 2010, with the share of the public holding strongly unfavorable views of the law outnumbering the share with strongly favorable views. A new analysis of Kaiser Family Foundation polling data finds that intensity gap began to close in spring 2017. The share with a “very favorable” view is now roughly equal to the share with a “very unfavorable” view.

Kaiser Health Tracking Poll: ACA, Replacement Plans, Women’s Health

The latest Kaiser Health Tracking Poll examines the public’s early attitudes towards the House Republican plan to repeal and replace the Affordable Care Act and finds that more expect the new plan will make things worse rather than better when it comes to the number of people with coverage and costs for those buying insurance on their own. The survey also measures public support for continuing current federal Medicaid funding to Planned Parenthood, gauges the importance of various ACA provisions for women’s and children’s health, and revisits the public’s knowledge on key provisions included in the health care law.

ACA Mandate Repeal May Be Less Popular Than GOP Thinks

In this Axios column, Drew Altman discusses how public opinion seems to flip on eliminating the individual mandate as part of the tax legislation, from for it to against, when the public considers the consequences.

Tracking Section 1332 State Innovation Waivers

This interactive map shows the status of all Section 1332 waivers requested by states. The Affordable Care Act (ACA) allows states to apply for innovation waivers to alter key ACA requirements in the individual and small group insurance markets and can be used to shore up fragile insurance markets, address unique state insurance market issues, or experiment with alternative models of providing coverage to state residents.

Medicaid: What to Watch in 2018 from the Administration, Congress, and the States

Medicaid provides health insurance coverage for about one in five Americans and is the largest payer for long-term care services in the community and nursing homes. Efforts in 2017 to repeal and replace the Affordable Care Act (ACA) and cap federal financing for Medicaid were unsuccessful but help to set the stage for 2018. As 2018 begins, there is a focus on administrative actions using Medicaid Section 1115 demonstration waivers, state actions on Medicaid expansion, and funding for the Children’s Health Insurance Program (CHIP) and other federal health care priorities. Medicaid in 2018 is also likely to continue to be part of both federal and state budget deliberations. Pressures to control the federal deficit may reignite efforts to reduce or cap federal Medicaid spending. In addition, Governors will soon release proposed budgets for state FY 2019 that will need to account for uncertainty around CHIP and Medicaid, changes in the economy and the effects of the recent tax legislation as well as funding for rising prescription drugs and initiatives to combat the opioid epidemic. This brief examines these issues.

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California.