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: A Primer – Key Information on the Nation’s Health Coverage Program for Low-Income People
This Medicaid primer provides an overview of the nation’s largest health coverage program, which covers more than 62 million low-income individuals, including children and families, people with disabilities and seniors who are also covered by Medicare. Medicaid also is the dominant source of the country’s long-term care financing. The program will expand significantly under the Affordable Care Act in 2014.
Issue Brief Read MoreSmall Area Variations and the ACA’s Coverage Expansions
A new Kaiser analysis sheds light on how the country might react to the Affordable Care Act (ACA) when it is implemented. It looks at how the benefits of the ACA’s coverage expansions will vary around the country by census areas (technically, Public Use Microdata Areas, or PUMAs). PUMAs are…
Perspective Read MoreHow is the Affordable Care Act Leading to Changes in Medicaid Today? State Responses to Five New Options
This policy brief examines how states in every region have responded to five key opportunities available under the health reform law to help them prepare for the significant expansion of Medicaid in 2014. The options covered in the brief include incentives for states to get an early start on the…
Issue Brief Read MorePulling it Together: 2012: The ACA, and More
What is remarkable about 2012 (and the current era in health policy) is how many big health policy issues and marketplace changes will be in play at the same time: HEALTH REFORM: There is the implementation of a historic but fragile health reform law, with a Supreme Court decision pending…
Perspective Read MoreA Historical Review of How States Have Responded to the Availability of Federal Funds for Health Coverage
This historical review finds that the availability of federal funds has served as an effective incentive for states to provide health coverage to meet the health and long-term care needs of their low-income residents despite state budget pressures. The brief examines the history of earlier experiences and provides important context for how states may respond as they weigh the costs and benefits of expanding their Medicaid programs in 2014 as called for under the Affordable Care Act.
Issue Brief Read MoreA Look At CBO Projections For Medicaid and CHIP
This brief examines the latest Congressional Budget Office (CBO) projections for federal Medicaid and CHIP spending over the 2014-2024 period. CBO’s budget projections, also known as “baseline” projections, reflect CBO’s best judgment about how the economy and other factors will affect federal revenues and spending under existing laws. The brief also examines CBO estimates of the coverage effects of the Affordable Care Act (ACA) on Medicaid and CHIP enrollment and spending. Understanding the CBO baseline estimates is important because they are the basis to evaluate the federal cost and coverage implications of proposed federal policy changes.
Issue Brief Read MoreMedicaid Eligibility, Enrollment Simplification, and Coordination under the Affordable Care Act: A Summary of CMS’s March 23, 2012 Final Rule
This brief provides a summary of the Centers for Medicare and Medicaid Services’ (CMS) March 23, 2012 final rule to implement the ACA provisions relating to Medicaid eligibility, enrollment simplification and coordination. The rule, which is effective Jan. 1, 2014, lays out procedures for states to implement the Medicaid expansion…
Issue Brief Read MoreExplaining Health Care Reform: Medical Loss Ratio (MLR)
This fact sheet explains the Medical Loss Ratio requirement under the Affordable Care Act (ACA). The MLR provision limits the portion of premium dollars health insurers may spend on administration, marketing, and profits. Under health care reform, health insurers must publicly report the portion of premium dollars spent on health care and quality improvement and other activities in each state they operate. Insurers failing to meet the applicable standard must pay rebates to consumers and businesses.
Fact Sheet Read MoreCan We Learn From ACA Implementation and Improve the Law?
Senator Baucus made headlines recently when he predicted a “train wreck” for Obamacare. David Brooks predicted “chaos” in a recent column. In a news conference, the President offered a different perspective. “There’ll still be, you know, glitches and bumps…. That’s pretty much true of every government program that’s ever been…
Perspective Read MoreKey Lessons from Medicaid and CHIP for Outreach and Enrollment Under the Affordable Care Act
The Affordable Care Act (ACA) will significantly increase coverage options through an expansion of Medicaid and the creation of new health insurance exchange marketplaces. However, effective outreach and enrollment efforts will be key to ensuring that new coverage opportunities translate into increased coverage. Based on a review of existing research,…
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