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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What Are the Implications of Repealing the Affordable Care Act for Medicare Spending and Beneficiaries?

The 2010 Affordable Care Act (ACA) included many provisions affecting the Medicare program and the 57 million seniors and people with disabilities who rely on Medicare for their health insurance coverage. This brief explains the Medicare provisions in the ACA and explores the implications for Medicare and beneficiaries of repealing these provisions.

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Obamacare Debate: Where GOP Governors Stand on Repeal and Replace

As congress prepares to vote on repeal of the Affordable Care Act, Drew Altman discusses whether Republican governors and congressional Republicans will be at odds over key issues when it comes to repealing and replacing the law in this Wall Street Journal Think Tank column.

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New Interactive Map with Local Data: Estimated 2016 ACA Marketplace Enrollment by Congressional District

As the 115th U.S. Congress deliberates the future of the Affordable Care Act, also known as Obamacare, a new interactive map from the Kaiser Family Foundation provides estimates of the number of people in each congressional district who enrolled in a 2016 ACA marketplace health plan and the political party of each district’s representative as of January. The analysis also includes maps charting by state the total number of people enrolled under the ACA Medicaid expansion in 2015, along with the political parties of the governors and U.S. senators.

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Comparison of Medicare Provisions in Recent Bills and Proposals to Repeal and Replace the Affordable Care Act

Repealing and replacing the Affordable Care Act is a top priority of the Trump Administration and the Republican leadership, which could have implications for the Medicare program. This brief provides a side-by-side comparison of the Medicare-related provisions in six bills and proposals that would repeal the ACA, excluding proposals that would not directly affect Medicare.

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Data Note: Estimated Medicaid Savings in the House Budget Resolution from March 2016

While the current Budget Resolution under consideration will set the framework for a repeal of the ACA, the Budget Resolution that passed in March 2016 provides insight into other Medicaid cuts that could be considered by Congress later this year. This Data Note examines proposed reductions in federal Medicaid funding under the March 2016 House Budget Resolution.

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JAMA Forum: What Might an ACA Replacement Plan Look Like?

Larry Levitt’s January 2017 post explains the logistics of a “repeal and delay” approach to the Affordable Care Act, and outlines key elements of a proposed replacement plan from Rep. Tom Price, who is President Trump’s nominee for Secretary of Health and Human Services. The post is now available at The JAMA Forum.

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The Republican Health-care Plan the Country Isn’t Debating

In this Washington Post op-ed, Drew Altman discusses how Republicans’ ideas to change Medicaid and Medicare and repeal the Affordable Care Act would fundamentally change the federal role in health, calling it: the biggest change in health we are NOT debating.

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Pre-ACA Market Practices Provide Lessons for ACA Replacement Approaches

This brief examines insurance practices from before the Affordable Care Act (also known as Obamacare) and highlights challenges in providing access and stable coverage for people, along with issues that any ACA replacement plan will need to address.

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Key Issues in Children’s Health Coverage

This brief reviews children’s coverage today and examines what is at stake for children’s coverage in upcoming debates around CHIP funding, repeal and replacement of the ACA, and Medicaid restructuring.

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Listening to Trump Voters with ACA Coverage: What They Want in a Health Care Plan

President Donald Trump and Republicans in Congress are moving to follow through on their campaign promise to repeal and replace the Affordable Care Act (ACA). To gain a better understanding of the personal experiences of Trump voters with health coverage provided through the ACA and the changes they hope to see in the health system moving forward, the Kaiser Family Foundation (KFF) held focus groups in December 2016 with Trump voters in cities in three battleground states (Michigan, Ohio, and Pennsylvania), who had coverage through the Marketplaces or through the Medicaid expansion. This brief and companion video highlight and summarize the range of perspectives expressed at the focus group sessions.

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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.