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. The Trump Administration’s actions and decisions also have affected the ACA marketplaces and will continue to reshape how Americans get health insurance into 2019 and beyond.

Featured Affordable Care Act Resources

Mar 26, 2019

Potential Impact of Texas v. U.S. Decision on Key Provisions of the Affordable Care Act

On December 14, 2018, a federal trial court judge ruled that the entire Affordable Care Act (ACA) is unconstitutional in Texas v. U.S. While the trial court’s ruling is likely not the last word on the ACA’s constitutionality, this brief considers the complex and far-reaching impact were the entire law ultimately held to be invalid.

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Related Affordable Care Act Resources

Dec 19, 2018

6 Charts About Public Opinion On The Affordable Care Act

This compiles key polling data examining the favorability of the ACA and its provisions, including protections for people with pre-existing conditions and the law’s individual mandate penalty, which Congress eliminated effective in 2019.

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May 20, 2019 Issue Brief

An Update on Insurance Coverage Among People with HIV in the United States

This analysis provides national estimates of insurance coverage among people with HIV and finds about 1 in 10 are uninsured, similar to the share among the general population following the ACA’s coverage expansions. Medicaid is the single largest source of coverage for people with HIV due to the ACA’s Medicaid expansion. The analysis also looks at access to Ryan White program services, and the impact of coverage and the Ryan White program on people with HIV’s ability to achieve sustained viral suppression.

May 17, 2019 Issue Brief

Coverage for Abortion Services in Medicaid, Marketplace Plans and Private Plans

This brief reviews current federal and state policies on Medicaid and insurance coverage of abortion services. It presents national and state estimates on the availability of abortion coverage for women enrolled in private plans, Affordable Care Act (ACA) Marketplace plans and Medicaid.

May 13, 2019 Issue Brief

Status of State Medicaid Expansion Decisions: Interactive Map

This page displays an interactive map of the current status of state decisions on the Affordable Care Act’s Medicaid expansion. Additional Medicaid expansion resources are listed (with links) below the map.

May 10, 2019 Fact Sheet

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.

May 8, 2019 News Release

Individual Market Insurers Are Expecting to Pay a Record $800 Million in Rebates to Consumers for Excessive Premiums in 2018

Individual market insurers are expecting to return to consumers a record total of about $800 million in excess premiums for 2018, a year in which the insurance companies posted their best annual financial performance under the Affordable Care Act to date, finds a new KFF analysis. The rebates to more…

May 8, 2019 Perspective

The Silent Affordability Crisis Facing Sick People

In this Axios column, Drew Altman shows that employer coverage for lower wage workers is much worse than ACA marketplace coverage for similar populations. It’s a bigger problem we need to talk about more, he says.

May 7, 2019 Issue Brief

Individual Insurance Market Performance in 2018

Individual market insurers are expecting to return to consumers a record total of about $800 million in medical loss ratio rebates for 2018, a year in which the insurance companies posted their best annual financial performance under the Affordable Care Act to date. Financial results for 2018 suggest that insurers in the individual market are generally returning to or exceeding profitability levels seen before 2014, when ACA insurance market rules took effect, including the requirement to cover people with pre-existing conditions.

May 3, 2019 News Release

Poll Finds Most Americans Oppose the Trump Administration’s Changes to Restrict Title X Family Planning Funds from Clinics that also Provide or Refer for Abortion

A new KFF poll of the public’s views on reproductive health issues finds most Americans, including majorities of women of reproductive age, are concerned that access to women’s reproductive health and preventive care services may be limited by the Trump administration’s changes to Title X, the nation’s federal family planning…

May 3, 2019 Poll Finding

KFF Poll: Public Opinion and Knowledge on Reproductive Health Policy

The latest KFF Poll examines the public’s attitudes towards different facets of reproductive health care in light of recent policy changes made by the Trump administration. This poll examines attitudes towards major changes to the Title X program and attitudes toward state-level laws restricting abortions after a fetal heartbeat has been detected. The poll also looks at public awareness of provisions related to women’s health that are part of the 2010 Affordable Care Act.

April 30, 2019 Issue Brief

From Ballot Initiative to Waivers: What is the Status of Medicaid Expansion in Utah?

The Utah legislature significantly changed and limited the Medicaid coverage expansion that was adopted by the voters through a ballot initiative in November 2018. This issue brief explains new provisions in Utah’s recently amended Section 1115 Medicaid waiver and the forthcoming amendments that the state is expected to submit to CMS, including a request for enhanced ACA federal matching funds for a partial capped expansion.