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Did the Affordable Care Act Make Health Care More Affordable?

The expiration of the ACA’s enhanced premium tax credits at the start of 2026, combined with rising insurer premiums, put a spotlight on health care affordability that extends beyond Marketplace enrollees. KFF’s Cynthia Cox examines the ACA’s record and the broader underlying question it raises: what’s a fair price for Americans people to pay for health care?

The ACA MarketplaceS

In Preliminary Rate Filings, ACA Marketplace Insurers Largely Propose Double-Digit Premium Increase For 2027, Following a Steep Climb This Year 

ACA Marketplace insurers are proposing a median premium increase of 14% for 2027— indicating a likely second consecutive year of double-digit increases, according to a new analysis of preliminary rate filings in 16 states and DC. If these increases hold, typical premiums for insurers participating in the ACA Marketplaces would jump by more than one-third between 2025 and 2027.

The Average Marketplace Deductible Grew by About $1,000 Per Person in 2026, With More Enrollees Shifting to Higher-Deductible Plans as Enhanced Tax Credits Expired

The average Affordable Care Act (ACA) Marketplace deductible experienced the steepest increase in history—growing by 37% or over $1,000, from $2,759 in 2025 to $3,786 in 2026 as enhanced premium tax credits expired, according to a new KFF analysis. After the enhanced tax credits ended, many Marketplace shoppers shifted toward lower-premium, higher-deductible plans.

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  • Observé que los planes de salud en el mercado están caratulados como Bronce, Plata, Oro y Platino. ¿Qué significa?

    FAQs

    Los planes en el mercado se dividen en categorías: Bronce, Plata, Oro o Platino, en función de la cantidad de costos compartidos que requieren. El costo compartido se refiere a los deducibles, copagos, y coseguros del plan de salud. Para la mayoría de los servicios cubiertos, deberá pagar parte del costo, al menos hasta que alcance el límite anual de gastos de bolsillo. La excepción es para los servicios de salud preventivos, que los planes…

  • ¿Cuánto tiempo pasa desde que me inscribo hasta que la cobertura entra en vigencia?

    FAQs

    En la mayoría de los estados, si se inscribe en un plan privado de salud en cualquier momento entre el 1 de noviembre y el 15 de diciembre, y realiza el primer pago de la prima antes de la fecha límite para su plan, su nueva cobertura de salud comenzará el 1 de enero. Si se inscribe después del 15 de diciembre, su cobertura de 2026 comenzará el 1 de febrero. Averigüe con el mercado…

  • ¿Cuándo puedo inscribirme en un plan privado de salud a través del mercado?

    FAQs

    En general, una persona solo puede inscribirse en la cobertura de un plan de salud no grupal durante el período de inscripción abierta. Para la cobertura de 2026, el período de inscripción abierta en los estados que usan cuidadodesalud.gov comienza el 1 de noviembre de 2025 y se cierra al final del día 15 de enero de 2026. Las siguientes estados tienen distintas fechas de finalización: Idaho: 15 de diciembre Massachusetts: 23 de enero Virginia:…

  • Compramos seguro en el mercado en nuestro estado, pero nuestro hijo va a la universidad en otro. Queremos tenerlo en nuestro plan. ¿Podemos hacerlo?

    FAQs

    Sí. Su hijo puede inscribirse en su plan familiar del Mercado, incluso si vive fuera del estado. Sin embargo, es posible que su hijo deba regresar a casa para acceder a la atención dentro de la red de su plan. Si reciben servicios de atención médica en otro estado, los proveedores de salud pueden estar fuera de la red de su plan, y es posible que usted tenga que pagar copagos o coseguros de costos…

  • Health Insurer Financial Performance in 2024

    Issue Brief

    This analysis of trends in health insurers’ financial data shows that insurers’ gross margins per enrollee dipped slightly in 2024 across four markets, remaining highest in the Medicare Advantage market, followed by the individual (non-group) market, the fully insured group (employer) market, and Medicaid managed care. The analysis also examines insurers’ medical-loss ratios across the four markets.

  • Explaining Health Care Reform: Key Changes to the Medicare Part D Drug Benefit Coverage Gap

    Issue Brief

    On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act into law. The health reform law, as modified by the Health Care and Education Reconciliation Act of 2010 which passed the House of Representatives on March 21, 2010 and is under consideration in the Senate, makes several key changes to the Medicare Part D drug benefit to reduce Part D enrollees’ out-of-pocket liability when they reach the coverage gap, known as…

  • Health Insurance Exchanges: Can States and the Federal Government Meet the Deadline?

    Event Date:
    Event

    The Alliance for Health Reform and the Commonwealth Fund sponsor a July 27 briefing to discuss how states are facing implementation and evaluation deadlines in regards to health insurance exchanges. Speakers will explore such questions as: What needs to happen between now and January 2014 for states to successfully implement exchanges and other aspects of health reform? What are options for states if they fail to meet the upcoming November deadline for declaring their exchange…

  • Claims Denials and Appeals in ACA Marketplace Plans in 2024

    Issue Brief

    This brief analyzes federal transparency data published by CMS on claims denials and appeals for Marketplace plan offered on HealthCare.gov in 2024, and finds insurers denied 19% of in-network claims. Consumers rarely appeal denied claims.