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Affordability

A promotional image for the the KFF Health Policy 101 Health Care Costs and Affordability chapter

Health Policy 101 is a comprehensive guide covering fundamental aspects of U.S. health policy and programs, including Medicare, Medicaid, the Affordable Care Act, employer-sponsored insurance, the uninsured population, health care costs and affordability, women's health issues, and health care politics. The Health Care Costs and Affordability chapter explores trends in health care costs in the U.S. and the factors that contribute to this spending. It also examines how health care spending varies across the population, the impact of costs on care affordability and individuals' overall financial vulnerability.

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  • The Affordable Care Act 101

    Feature

    This Health Policy 101 chapter provides an overview of the Affordable Care Act (ACA), a major reform of the U.S. health care system aimed at reducing high uninsured rates and alleviating issues like high out-of-pocket costs and coverage exclusions for preexisting conditions. The ACA significantly altered many aspects of the health system and the chapter explores its mechanisms, such as the Health Insurance Marketplaces, and the evolution of the law since its passage in 2010 to the changes in the 2025 budget reconciliation law.

  • 2025 KFF Marketplace Enrollees Survey

    Poll Finding

    This survey explores how ACA Marketplace enrollees expect to respond if their premium payments doubled as expected in 2026 when enhanced premium tax credits are set to expire. About a third would very likely look for a lower-cost plan, even if it had higher deductibles, and about a quarter would very likely end up uninsured. The survey also examines how increased health care costs may affect their finances and the potential impact in next year's elections.

  • Insurance Markets in a Post-King World

    Perspective

    This perspective addresses how insurance markets might respond if the US Supreme Court sides with the plaintiffs in the King v. Burwell case. The case challenges the legality of premium and cost-sharing subsidies for low- and middle-income people buying insurance in states where the federal government rather than the state is operating the marketplace under the Affordable Care Act (ACA).

  • Is ACA Coverage Affordable for Low-Income People? Perspectives from Individuals in Six Cities

    Issue Brief

    This brief presents findings from focus groups with low-income Medicaid and Marketplace enrollees in six cities: Baltimore, MD; Columbus, OH; Oakland, CA; Richmond, VA; St. Louis, MO; and Tampa, FL. It explores their experiences signing up for coverage; their perceptions of whether the costs they pay for their coverage are affordable; their experiences accessing care; and the impact of out-of-pocket costs on their ability to get needed care. It provides insights into the ongoing financial struggles facing low-income individuals and the problems they confront affording health coverage.

  • In Focus: Listening to Enrollees with Affordable Care Act Coverage Who Voted for Trump

    News Release

    As Republicans in Washington pursue efforts to repeal and replace the Affordable Care Act, what do enrollees in ACA marketplaces and state Medicaid expansions who voted for President Trump want in a health care plan? The Kaiser Family Foundation asked some of them in six focus groups convened in December in Michigan, Ohio, and Pennsylvania…