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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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  • Atención de salud en Puerto Rico y las Islas Vírgenes de los Estados Unidos: una revisión, a seis meses de las tormentas (Informe)

    Issue Brief

    Puerto Rico y las Islas Vírgenes de los Estados Unidos (USVI) sufrieron daños significativos en su infraestructura y sistemas de salud a causa del impacto de los huracanes Irma y María en septiembre de 2017. Basándose en entrevistas con residentes, partes interesadas clave, y en informes públicos, este informe proporciona una visión general del estado de los esfuerzos de recuperación, a seis meses de las tormentas, con un enfoque en los sistemas de atención médica.

  • Kaiser Health Tracking Poll: Preview of the Role of Health Care in the 2018 Midterm Campaigns

    Feature

    The latest KFF Health Tracking Poll finds health care ranking among the top issues voters want to hear candidates talk about during their congressional campaigns, with health care cost ranking as the top health care issue for voters across partisanship. However, for many voters, including one-third of Republican voters, a candidate’ position on President Trump will make the biggest difference in how they vote in 2018. This month’s poll also takes an in-depth look at…

  • Six Months ahead of the Midterm Elections, Democratic and Republican Voters’ Views about President Trump Outweigh their Views on Issues, Including Health Care

    News Release

    Who are the “Health Care Voters”? Mostly Women, and Mostly Planning to Vote Democratic As primary season for the 2018 midterm elections heats up, the latest Kaiser Family Foundation poll suggests the elections are shaping up more as a referendum on President Trump than on health care or any other issue. When asked what will make the biggest difference in how they vote in the Congressional elections, larger shares of Democrats and Republicans cite candidates’…

  • Health and Access to Care and Coverage for Lesbian, Gay, Bisexual, and Transgender (LGBT) Individuals in the U.S.

    Issue Brief

    Lesbian, gay, bisexual, and transgender (LGBT) individuals often face challenges and barriers to accessing needed health services and, as a result, can experience worse health outcomes. These challenges can include stigma, discrimination, violence, and rejection by families and communities, as well as other barriers, such as inequality in the workplace and health insurance sectors, the provision of substandard care, and outright denial of care because of an individual’s sexual orientation or gender identity. This issue…

  • Analysis: Most Short-Term Health Plans Don’t Cover Drug Treatment or Prescription Drugs, and None Cover Maternity Care

    News Release

    A new Kaiser Family Foundation analysis of short-term, limited duration health plans for sale through two major national online brokers finds big gaps in the benefits they offer. Through an executive order and proposed new regulations, the Trump Administration is seeking to encourage broader use of short-term, limited duration health plans as a cheaper alternative to individual market plans that comply with the Affordable Care Act’s requirements. Repeal of the individual mandate penalty – which…

  • Understanding Short-Term Limited Duration Health Insurance

    Issue Brief

    In late 2017, President Trump issued an executive order directing the Secretary of Health and Human Services to take steps to expand the availability of short-term health insurance policies. This brief provides background information on short-term policies and how they differ from ACA-compliant health plans. It also analyzes the short-term plans available through two major online brokers to assess how often they include coverage for mental health, substance abuse, prescription drugs and maternity care.

  • Brief Examines Efforts to Create Health Plan Options that Don’t Comply with the Affordable Care Act’s Rules

    News Release

    Though Congress last year failed to repeal key Affordable Care Act requirements for non-group health insurance that people buy themselves, the Trump Administration and some states are promoting other types of plans through regulatory changes that would allow the sale of products that skirt many of the ACA’s requirements. A new Kaiser Family Foundation brief examines four of those options and the tradeoffs involved if such loosely regulated markets take root as an alternative to…

  • Proposals for Insurance Options That Don’t Comply with ACA Rules: Trade-offs In Cost and Regulation

    Issue Brief

    This brief examines four options to promote the sale of health plan options in the individual or non-group market that are not subject to Affordable Care Act (ACA) requirements for other major medical health plans. It reviews the trade-offs involved if such loosely regulated markets take root as an alternative to the ACA-regulated market, particularly as the repeal of the individual mandate penalty takes effect next year.

  • The Left is Getting More Active on Health Care

    From Drew Altman

    In this Axios column, Drew Altman discusses data from the new KFF/Washington Post survey on activism in America showing the role support for the ACA is playing in motivating political participation, and how, in a reversal from the last election cycle, political energy is shifting from right to left on health care as a new election looms.