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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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  • The Health Care Priorities and Experiences of California Residents

    Report

    This survey by the Kaiser Family Foundation and California Health Care Foundation gauges California residents’ views on health care priorities facing the state’s new governor and legislature, including health care affordability, access to care, mental health and substance use treatment, and provider shortages. It also highlights Californians’ experiences in the health care system, as well as views on the Affordable Care Act, Covered California, Medi-Cal, and proposals to advance a single-payer health insurance system in…

  • Poll: Majorities Favor a Range of Options to Expand Public Coverage, Including Medicare-for-All

    News Release

    At a time when debate is beginning about a national Medicare-for-all plan and other approaches to expanding coverage through public programs, this month’s KFF Health Tracking poll examines Americans’ early opinion on a range of options under consideration. The poll finds majority support for four different approaches: 77 percent of the public, including most Republican (69%), favor allowing people between the ages of 50 to 64 to buy health insurance through Medicare; 75 percent, including…

  • KFF Health Tracking Poll – January 2019: The Public On Next Steps For The ACA And Proposals To Expand Coverage

    Feature

    This month's KFF Health Tracking Poll finds that about four in ten are aware of the federal judge's ruling that the ACA is no longer valid but once made aware, most disapprove of the ruling. This poll also examines the public's favorability toward expanding the role of public health care programs, and majorities across partisan groups have a favorable opinion of programs such as Medicare buy-in and Medicaid buy-in, with a national Medicare-for-all being less…

  • Medicaid: What to Watch in 2019 from the Administration, Congress, and the States

    Issue Brief

    Medicaid, the provider of health insurance coverage for about one in five Americans and the largest payer for long-term care services in the community and nursing homes, continues to be a key part of health policy debates at the federal and state level. Important Medicaid issues to watch in 2019 include Medicaid expansion developments amid ongoing litigation about the ACA’s constitutionality as well as Medicaid demonstration waiver activities, including those focused on work requirements and…

  • Abortion Coverage in the ACA Marketplace Plans: The Impact of Proposed Rules for Consumers, Insurers and Regulators

    Issue Brief

    On November 7, 2018, a day after the 2018 midterm elections, the Trump Administration issued a proposed regulation to address “Exchange Program Integrity.” A major element of this proposed rule would affect insurers, consumers, and state insurance regulators in the states that either allow or require abortion coverage. The Affordable Care Act (ACA) allows states to ban plans from offering abortion as a benefit on their Qualified Health Plans (QHPs) and requires plans that cover…

  • If the Affordable Care Act is Struck Down, Nearly All Americans Would Be Affected in Some Way

    News Release

    The Affordable Care Act’s changes to the nation’s health care system are so widespread that nearly all Americans would be affected in some way if a federal judge’s decision ruling the entire law unconstitutional is upheld, according to a new analysis from KFF (the Kaiser Family Foundation). While the changes to the individual insurance market – including protections for people with pre-existing conditions, creation of insurance marketplaces, and premium subsidies for low and modest income…

  • The ACA Ruling Shows How the Times Have Changed on Health Care

    From Drew Altman

    In this Axios column about the Texas court decision, Drew Altman shows that many provisions of the Affordable Care Act are even more popular than protections for pre-existing conditions, the issue which put Republicans on the defensive and helped Democrats in the midterm elections.