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This brief analyzes 2017 Affordable Care Act (ACA) marketplace data on premium and insurer participation, including data made available through Healthcare.gov on October 24, 2017, as well as data collected from states that run their own exchange websites.
Given recent news about some high-cost prescription drugs and the debate about who should pay for them, this month’s Kaiser Health Tracking Poll has a special focus on the issue. Nearly three-quarters of the public think that the cost of prescription drugs is unreasonable. Americans place much of the blame with the drug companies saying they set prices too high and that company profits are a major factor in drug pricing. The poll also finds that most of the public still hasn’t heard much about the Supreme Court case on whether people in states with federal marketplaces are eligible for financial assistance to purchase health insurance. Most feel that Congress and states should act if the Court rules for the plaintiffs, but there is no agreement among partisans.
The Affordable Care Act, also known as Obamacare, and leading replacement proposals rely on refundable tax credits to help individual market enrollees pay for premiums, although the credit amounts are set quite differently. This analysis compares estimates of an average 2020 tax credit amount under the ACA with averages under the House Republicans' American Health Care Act, introduced March 6, 2017.
This election is a choice in health between aggressive incrementalism and a sharp right-hand turn in federal policy and spending, but ... no one should doubt the capacity of our system and institutions to thwart dramatic change in any direction.
These resources are for anyone shopping (or helping someone shop) for health coverage within the health insurance marketplaces created through the Affordable Care Act (also known as the ACA or Obamacare.)
In a new column, President and CEO Dr. Drew Altman forecasts eight things to look for in health policy in 2026. “First and foremost,” he writes, “is the role health care affordability will play in the midterms.” And, he notes: “The average cost of a family policy for employers could approach $30,000 and cost sharing and deductibles will rise again after plateauing for several years.”
In his latest column, President and CEO Drew Altman discusses how, with nearly half, or about 10 million MAGA supporters and Republicans receiving coverage through the ACA Marketplaces, the policy changes and cuts being considered by Republicans to the Marketplaces will directly affect their own voters. Altman writes: "Republicans are no longer interested in repealing the ACA but seem comfortable shrinking it significantly if they can, so long as they don’t touch protections for pre-existing conditions, which is now a political third rail."
So far in 2025, ACA Marketplace enrollment has more than tripled since 2020 in at least 6 states: Texas, Mississippi, Georgia, Louisiana, West Virginia, and Tennessee. All of these states were won by President Trump.
Vance’s debate comment likely refers to state reinsurance waivers, largely approved by the Trump Administration. These waivers aimed to lower unsubsidized premiums by offsetting insurer costs for very sick enrollees.
It is worth a refresher on how the ACA protects people with pre-existing conditions. It’s also worth asking whether and how an alternative would do the same.
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