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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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  • Some Can Get Marketplace Plans With No Premiums,Though With Higher Deductibles and Cost-Sharing

    News Release

    Many low-income consumers who are eligible for federal financial help under the Affordable Care Act can get a bronze-level plan and pay nothing out-of-pocket in premiums in more than 2,000 counties next year, depending on their annual income, according to a new analysis from KFF (the Kaiser Family Foundation). Such plans come with higher deductibles and out-of-pocket maximums, however. The analysis finds that the ACA’s premium tax credits would cover the full premium of the lowest-cost bronze…

  • New Regulations Broadening Employer Exemptions to Contraceptive Coverage: Impact on Women

    Issue Brief

    This brief explains the contraceptive coverage rule under the ACA, the impact it has had on coverage, and how the new regulations issued by the Trump administration have changed the contraceptive coverage requirement for employers with religious and moral objections to contraception and the women who receive coverage through their plans.

  • More Insurers Are Participating in the ACA Marketplaces in 2019

    News Release

    Insurer participation in the Affordable Care Act’s health insurance marketplaces is rising in 2019, finds a new analysis from KFF (the Kaiser Family Foundation).The increase follows consecutive years of improving insurance company profits and shows up in several different ways: Going into 2019, 608 counties nationwide are gaining at least one insurer in the marketplace, while only five counties will lose an insurer. In 2019, roughly 17 percent of enrollees (living in 37 percent of…

  • The New Health Care Agenda: Gridlock, Lots of Hearings

    From Drew Altman

    In an Axios column, Drew Altman analyzes what the midterm election means for the health policy agenda between now and 2020--mostly political positioning and gridlock in Congress, with most of the action affecting people in the states. 

  • What Does the Outcome of the Midterm Elections Mean for Medicaid Expansion?

    Fact Sheet

    While not typically an election issue, Medicaid — particularly the Medicaid expansion created under the Affordable Care Act (ACA) — was an important issue in the 2018 midterm elections in a number of campaigns throughout the country. This fact sheet highlights key states in which the results of the 2018 midterm elections have implications for Medicaid adoption or implementation. States examined include those that had Medicaid expansion ballot initiatives as well as states that have…

  • 2019 Calculadora del Mercado de Seguros Médicos

    Interactive

    Nota: esta calculadora refleja las primas para 2019. Esta calculadora ilustra las primas (el costo mensual de su seguro) y subsidios para las personas que compran seguro médico por su propia cuenta en el nuevo mercado de seguros de salud (o de intercambio) creado por la Ley de Cuidado de Salud a Bajo Precio (Affordable Care Act, ACA, en inglés). Con esta calculadora, usted puede introducir diferentes niveles de ingresos, edades, y el tamaño de…

  • 2019 Health Insurance Marketplace Calculator

    Interactive

    The Health Insurance Marketplace Calculator, updated with 2019 premium data, provides estimates of health insurance premiums and subsidies for people purchasing insurance on their own in health insurance exchanges (or “Marketplaces”) created by the Affordable Care Act (ACA). With this calculator, you can enter your income, age, and family size to estimate your eligibility for subsidies and how much you could spend on health insurance.

  • Short-Term Health Insurance Plans Charge Less than Half as Much in Premiums as ACA Plans By Excluding Pre-Existing Conditions and Severely Limiting Benefits

    News Release

    Short-term health insurance plans offer a trade-off for consumers: substantially lower premiums than plans that comply with the Affordable Care Act, but much less protection if they get sick and need care. Just how much cheaper are the premiums and what are consumers giving up to get them? A new KFF (Kaiser Family Foundation) analysis finds short-term plans are able to charge premiums 54 percent lower than ACA-compliant plans, by excluding pre-existing conditions and severely…