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.
Featured Affordable Care Act Resources

Potential Costs and Impact of Health Provisions in the Build Back Better Act
A summary of 10 of the major health coverage and financing provisions of the current Build Back Better Act, with discussion of the potential implications for people and the federal budget.
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Related Affordable Care Act Resources
- 5 Charts About Public Opinion on the Affordable Care Act
- A Closer Look at the Uninsured Marketplace Eligible Population Following the American Rescue Plan Act
- Eligibility for ACA Health Coverage Following Job Loss
- Pre-Existing Condition Prevalence for Individuals and Families
- Building on the Evidence Base: Studies on the Effects of Medicaid Expansion, February 2020 to March 2021
- FAQs: Health Insurance Marketplace and the ACA
- Explaining Health Care Reform: Questions About Health Insurance Subsidies
- Status of State Medicaid Expansion Decisions: Interactive Map
- Preventive Services Tracker
- Tracking Section 1332 State Innovation Waivers

How Marketplace Costs and Premiums will Change if Rescue Plan Subsidies Expire
In this Policy Watch we explore the potential impact of the expiration of the American Rescue Plan Act’s enhanced financial help and new eligibility for the Affordable Care Act’s health insurance Marketplace federal subsidies. While the COVID-19 relief legislation passed earlier this year provides greater subsidy assistance through 2022, Democrats in Congress are currently considering making the temporary federal help permanent or extending it as part of their planned budget reconciliation legislation.
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Medicaid Covers People with Pre-Existing Conditions, Too
In recent weeks, the possible overturning of the Affordable Care Act (ACA) in court and the upcoming election have focused attention on the issue of protections for people with pre-existing conditions. While the focus has been on the ACA’s private insurance protections, Medicaid also plays a significant role in covering people with pre-existing conditions.
Blog Read MoreTracking Poll: A Large and Growing Majority, Including Republicans, Does Not Want the Supreme Court to Overturn the ACA’s Protections for People with Pre-Existing Conditions
As the Senate considers Judge Amy Coney Barrett’s nomination to the Supreme Court, the October KFF Health Tracking Poll finds a large majority (79%) of the public do not want the Court to overturn the Affordable Care Act’s protections for people with pre-existing medical conditions, up 17 percentage points since…
News Release Read MoreA Closer Look at the Uninsured Marketplace Eligible Population Following the American Rescue Plan Act
This analysis examine key demographic characteristics of the uninsured population eligible for subsidies to buy Marketplace coverage following the American Rescue Plan.
Issue Brief Read MoreKFF Health Tracking Poll – May 2021: Prescription Drug Prices Top Public’s Health Care Priorities
The latest KFF Health Tracking Poll explores the public’s views on the U.S. role in distributing COVID vaccines to other countries, health care priorities for Congress, prescription drug regulations and price negotiations, and affordability changes in the COVID-19 relief bill.
Poll Finding Read MoreSupplemental Security Income for People with Disabilities: Implications for Medicaid
This issue brief describes key characteristics of SSI enrollees, explains the SSI eligibility criteria and eligibility determination process, and considers the implications of changes in the SSI program for Medicaid, including the effects of the COVID-19 pandemic and resulting economic downturn as well as proposals supported by President Biden that Congress might consider.
Issue Brief Read MoreNew Resource Outlines Efforts to Expand Screening and Counseling for Intimate Partner Violence
Two resources give an overview of intimate partner violence (IPV) in the U.S. and insurance coverage for screening and counseling.
News Release Read MoreAnalysis: 4.7 Million Uninsured People Nationally Could Get a No-Premium Bronze Plan in the ACA Marketplace,Though Deductibles Would be High
As the Affordable Care Act’s open enrollment period nears an end in most areas this week, a new KFF analysis finds that 4.7 million currently uninsured people could get a bronze-level plan for 2020 and pay nothing in premiums after factoring in tax credits, though the deductibles would be high.…
News Release Read MoreNearly 9 Million Uninsured Americans Could Get Free or Subsidized Health Insurance if the Biden Administration Re-Opens ACA Marketplace Enrollment in Response to COVID-19
Four million uninsured people could get an ACA bronze plan with no premium payment and 4.9 million others could get subsidies to offset the cost of such a plan if the Biden Administration were to re-open ACA marketplace enrollment, a KFF analysis finds. Four million uninsured people could get an…
News Release Read MoreACA Open Enrollment Matters for Medicaid Coverage, Too
President Biden’s January 28th executive order to reopen enrollment in the federal ACA Marketplace from February 15 through May 15, combined with $50 million in federal spending on outreach and education about ACA coverage options, has the potential to reach millions of people who were uninsured prior to or have lost coverage during the pandemic. As of 2019, there were 29 million non-elderly uninsured people, and the majority (57%) were eligible for financial assistance through the ACA Marketplaces (33%) or Medicaid (25%). KFF estimates indicate that nearly nine million uninsured people could be eligible for free or subsidized Marketplace coverage during the new enrollment period. Importantly, these actions to facilitate enrollment in ACA Marketplace coverage will also likely lead eligible low-income people to enroll in Medicaid coverage.
Blog Read MoreHealth Insurer Financial Performance Through September 2020
In this brief, we analyze third quarter data from 2018 to 2020 to examine how insurance markets performed financially through the end of September. Average margins remained relatively high compared to the same point in recent years, suggesting many insurers remained profitable even as non-COVID-related care returned in the summer and fall.
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