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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The Biggest Health Care Reform in a Decade Could Lower Your Costs

Larry Levitt writes about the political and practical impact of the health care provisions in the Inflation Reduction Act  in The New York Times guest essay, “The Biggest Health Care Reform in a Decade Could Lower Your Costs.” 

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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:

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August 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…

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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.

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ACA’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.

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An 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.

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Marketplace 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…

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Claims 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.

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Falling 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 .

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Data 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.

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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.