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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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  • How Affordability of Employer Coverage Varies by Family Income

    Issue Brief

    This analysis looks at the share of family income people with employer-based coverage pay toward their premiums and out-of-pocket payments for medical care. The cost of employer sponsored health insurance—including premiums, deductibles, and other out-of-pocket costs—has risen steadily over time.

  • 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. 

  • Kaiser Health Tracking Poll: Election 2008 – June 2008

    Poll Finding

    The latest Kaiser Health Tracking Poll: Election 2008 poll finds that the recent economic downturn continues to create serious financial problems for most Americans. When asked about the impact of recent economic changes, nearly six in 10 adults (59 percent) report having a "serious problem" with one of seven major financial issues, including one in four who cite paying for health care as a serious problem. Not surprisingly, with gas prices topping $4 per gallon…

  • Explaining Health Care Reform: What Is An Employer “Pay-or-Play” Requirement?

    Issue Brief

    To broaden coverage, some health reform proposals would require employers to offer coverage or pay to help finance subsidies for those without access to affordable coverage. These types of reforms are often referred to as “pay-or-play” policies. The brief explains the concept and policy implications of employer pay-or-play proposals, which can vary in terms of the level of coverage required for compliance, the cost of the penalty to employers who do not offer, and whether…

  • Kaiser Health Tracking Poll – June 2009

    Poll Finding

    The June Kaiser Health Tracking Poll finds remarkable stability in public opinion on health reform as Congressional committees begin to hone in on the details of their health reform bills and debate intensifies. A solid majority of the American people continue to believe that health reform is more important than ever given the country’s economic problems. A solid majority of the American people continue to believe that health reform is more important than ever given…

  • Pulling it Together: The Health Care Industry’s Second Voluntary Effort

    Perspective

    The announcement that health care industry groups plan to put on the table voluntarily a package of proposals to shave $2 trillion off the rate of increase in health spending over the next ten years immediately conjures up the image of the Voluntary Effort or VE launched with similar fanfare in the Carter administration.  Back then the industry used the VE to fend off Jimmy Carter's efforts to aggressively control the costs of hospital care…

  • Health Reform Opportunities: Improving Policy for Dual Eligibles

    Issue Brief

    As the nation considers national health reform, this brief provides an overview of opportunities to realign federal and state policy for the dual eligibles to promote a more rational, cost-efficient system for 9 million of the poorest, sickest and highest-cost people covered by both Medicaid and Medicare. Navigating two programs with different rules and financing incentives is complex for beneficiaries and providers, impedes efforts to improve care coordination and results in cost-shifting between programs that…

  • Kaiser Health Tracking Poll — August 2009

    Poll Finding

    The August Kaiser Health Tracking Poll finds a slim majority of Americans continues to favor moving forward on health care reform now despite an intensifying ad war and a political climate of contentious town hall meetings that coincide with rising concerns about the reform effort. Fifty-three percent of the public believes that tackling health reform is more important than ever, compared to 42 percent who say we cannot afford to take on health care reform…

  • Pulling it Together: Simple Arithmetic

    Perspective

    This week we put out our annual benchmark survey of employer health coverage and costs. Two numbers jumped off the pages. The first number was the average cost of a family health insurance policy in 2009: $13,375. To put that number in context, if you are an employer, you can hire an employee at the minimum wage for about $15,000 per year. If you are a consumer, you can rent an average two-bedroom apartment nationwide…