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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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  • ¿Debería reclamar el subsidio por adelantado, al final de año, o ambos?

    FAQs

    Eso depende de usted. Puede hacer que su crédito fiscal anual para las primas se pague directamente a su plan de salud cada mes para reducir su prima mensual de inmediato. O, si puede pagarlo, puede pagar la prima completa del plan de salud usted mismo por adelantado y cobrar el subsidio en una suma global el próximo año cuando presente su declaración de impuestos. O bien, puede hacer que parte del crédito fiscal se…

  • Consumer Choice in Health Care: How Could Reform Affect Our Choices? How Could We Make Better Choices?

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    The Alliance for Health Reform and the Robert Wood Johnson Foundation co-sponsored this event which brought together nationally known health policy experts for a conversation on consumer choice in health care. Panelists addressed the following questions: Why is choice of health care providers important? How much choice do we really have now? How much choice do we need? How might health reform affect our choices? In some instances, do we have too much choice? How…

  • On Health Care, Conservatives Protest Too Much

    From Drew Altman

    Lately conservatives have been feeling like losers in health care and complaining loudly about it. They don't like Obamacare or the increase in the government's role in health care or the federal spending it brings with it, even if those things result in coverage for more than 30 million uninsured Americans and new protections from the worst abuses in the health insurance industry. Actually, conservatives are winning at least as much as they are losing…

  • The Public’s Policy Agenda for the 113th Congress: Briefing and Panel Discussion

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    As the 113th Congress is sworn in, and President Barack Obama begins his second term of office, a comprehensive new Kaiser Family Foundation/Robert Wood Johnson Foundation/Harvard School of Public Health survey queried the public about their priorities for, and views on, a wide range of health and health policy issues. These include issues that will preoccupy federal lawmakers, such as the role of Medicare in the deficit reduction debate, as well as issues currently being…

  • Health Care on the Brink of the Fiscal Cliff

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    The Alliance for Health Reform and the Kaiser Family Foundation present a November 16 briefing to discuss the components of this key policy crossroads with a particular emphasis on the implications for health programs and the health care industry. Automatic cuts would not apply to Medicaid, but Medicare providers would experience 2 percent payment cuts. The reductions would likely be larger for discretionary health programs, such as those funded as part of the National Institutes…

  • Behavioral Health: Can Primary Care Help Meet the Growing Need?

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    The health reform law has specific provisions covering mental health and substance use conditions, as well as general provisions to benefit those in need of behavioral health services. While addressing unmet needs, the reform law provisions raise new challenges. Given their budgetary constraints, will states be able to expand capacity to meet the demands of increased enrollment? Will sacrifices in other benefits and services be needed in order to provide mental health parity? Will the…

  • Rural Health: Laying the Foundation for Health Reform

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    The Alliance for Health Reform and the Robert Wood Johnson Foundation co-sponsored this briefing to have a panel of experts answer questions about how some aspects of pending health reform proposals may have a substantial impact on rural care. What provisions in the various reform proposals affect rural health care? What particular challenges need to be overcome in order to improve care delivery in rural areas? What aspects of health reform will require special accommodation…