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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Five Things to Know about the Renewal of Extra Affordable Care Act Subsidies in the Inflation Reduction Act
As part of the Inflation Reduction Act, the Senate recently passed a three-year extension (through 2025) of enhanced subsidies for people buying their own health coverage on the Affordable Care Act Marketplaces. The enhanced subsidies increase the amount of financial help available to those already eligible and also newly expand subsidies to middle-income people, many of whom were previously priced out of coverage. Here’s what to know about the likely renewal of these subsidies:
Blog Read MoreAugust 11 Web Event: Understanding the Health Care Provisions in the Inflation Reduction Act
The Inflation Reduction Act includes several landmark health care provisions that would lower prescription drug costs for people with Medicare, reduce Medicare drug spending and extend enhanced subsidies for Affordable Care Act marketplace coverage. On Thursday, August 11, a panel of KFF experts held a web briefing to…
Event Read MoreStatus 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.
Issue Brief Read MoreACA’s Maximum Out-of-Pocket Limit Is Growing Faster Than Wages
This analysis finds that the ACA’s maximum out-of-pocket limit is likely to grow faster than wages and salaries, and is also expected to grow faster than the maximum out-of-pocket limit for Health Savings Account (HSA)-qualified health plans.
Issue Brief Read MoreAn Early Look at What is Driving Health Costs in 2023 ACA Markets
This analysis of marketplace insurers’ early rate filings in 13 states and the District of Columbia finds that they are seeking higher premium increases than in recent years, largely due to rising prices paid to hospitals, doctors and drug companies and increased use of services by enrollees.
Issue Brief Read MoreMarketplace Insurers Denied Nearly 1 in 5 In-Network Claims in 2020, though It’s Often Not Clear Why
Healthcare.gov marketplace insurers denied nearly one out of every five claims (18%) submitted for in-network services in 2020, though why the denial rates are so high and the ultimate consequences for consumers are difficult to access from the publicly available data, a new KFF analysis finds. The Affordable Care Act…
News Release Read MoreClaims Denials and Appeals in ACA Marketplace Plans in 2020
This analysis of transparency data released by the Centers for Medicare and Medicaid Services (CMS) finds that 18% of in-network claims were denied by healthcare.gov marketplace insurers in 2020, with denial rates varying widely from less than 1% to more than 80%. Consumers appealed just over one-tenth of 1% of those denied claims.
Issue Brief Read MoreFalling off the Subsidy Cliff: How ACA Premiums Would Change for People Losing Rescue Plan Subsidies
This post examines what would happen to ACA marketplace premiums for enrollees with incomes more than four times the federal policy level if the enhanced American Rescue Plan Act subsidies expire, including variations by state .
Blog Read MoreData Note: 2022 Medical Loss Ratio Rebates
We find that insurers estimate they will issue a total of about $1 billion in Medical Loss Ratio (MLR) rebates this year across all commercial markets under a provision of the Affordable Care Act (ACA) that limits the share of premiums that insurers can keep for administration, marketing, and profits.
Issue Brief Read MorePrivate Insurers Expect to Pay $1 Billion in Rebates to Consumers This Year for Setting Premiums Too High Relative to Medical Costs
Private insurance companies are expecting to pay out $1 billion in rebates to consumers this fall under an Affordable Care Act provision that requires insurers to spend the bulk of customers’ premium payments on care, a new KFF analysis finds. Rebates are based on insurers’ experiences over the previous three…
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