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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Early Analysis of 21 Major Cities Tracks ACA Marketplace Premium Changes, Insurer Participation, Uncertainty

As insurers grapple with continuing uncertainty surrounding 2018 Affordable Care Act (ACA) marketplaces, a new Kaiser Family Foundation analysis of initial filings in 21 major cities finds that changes in 2018 benchmark silver plan premiums are likely to range widely, from a decrease of 5 percent in Providence, R.I., to…

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Medicaid: What We Learned From the Recent Debate and What to Watch for in September 2017

The inclusion of major Medicaid changes in both the American Health Care Act (AHCA) that passed in the House and the Better Care Reconciliation Act (BCRA) considered in the Senate revealed that is hard to gain consensus on significant cuts and reforms to Medicaid. Medicaid has broad general support and intense support from special populations served by the program. In addition, proposed changes would have different implications across states due to significant program variation across states, including implementation of the ACA Medicaid expansion as well as other health status, demographic and state fiscal circumstances.

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2018 Elections: Key Medicaid Issues to Watch

Medicaid provides health insurance coverage for more than 76 million Americans, supplies funding for safety-net providers, and is the largest source of federal revenues for states. At this time last year, Congress was debating repeal and replace of the Affordable Care Act (ACA) as well as more fundamental changes to Medicaid financing. While federal legislative changes to Medicaid did not pass in 2017, the outcomes of the 2018 elections will shape program changes at both the state and federal levels of government. Our state-specific fact sheets provide background information about Medicaid and the upcoming elections.

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Demographics, Insurance Coverage, and Access to Care Among Transgender Adults

This analysis seeks to better understand the experiences of transgender people in the US health care system. We examine the demographic characteristics of transgender adults ages 18 and over and their access to health care and insurance coverage.

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How Threatening The ACA Again Could Hurt Trump With Independent Voters

In his Axios column, Drew Altman shows how threatening the Affordable Care Act in the U.S. Supreme Court, or overturning it, could hurt President Trump with independent voters, and says that could matter most in battleground states.

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The Status and Likely Impact of Final Regulations on Payments for Abortion Coverage in ACA Marketplace Plans

This brief summarizes the status and implications of the Trump Administration final regulations, published in December 2019, that change how ACA Marketplace plans that include coverage for abortion must bill and consumers must pay premiums for that coverage.

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Round 3: Legal Challenges to Contraceptive Coverage at SCOTUS

This brief explains how the new regulations issued by the Trump Administration would change the contraceptive coverage requirement for employers and affect women’s coverage, the legal positions for challenging and defending these regulations, the potential rulings, and the broader ramifications.

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Health Policy in 2020 Will Be Made in the States

With a questionable outlook for 2020 passage of legislation on prescription drug pricing and surprise medical bills, Drew Altman says the real action to watch in health policy is likely to be in the states.

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Analysis Examines the Affordable Care Act’s Impact on Nearly All Americans

A week after the 2020 elections, the Supreme Court is scheduled to hear arguments on a legal challenge, supported by the Trump administration, that seeks to overturn the Affordable Care Act, an outcome that would have major effects throughout the health care system as the law’s provisions have affected nearly…

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Analysis: A Proposal Like Biden’s Health Plan Would Lower the Cost of ACA Marketplace Coverage for Nearly All Potential Enrollees and Lower Premiums for Over 12 Million Workers With Employer Coverage

A new KFF analysis finds that expanding Affordable Care Act (ACA) premium subsidies like Democratic presidential nominee Joe Biden has proposed would lower the cost of Marketplace coverage for nearly all potential enrollees, including the uninsured and others currently priced out of the Marketplace. While the former Vice President’s plan…

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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.