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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 4 Arguments You Will Hear Against Drug Price Negotiation

    Perspective

    As the Biden administration begins the process of negotiation drug prices for Medicare as authorized in the Inflation Reduction Act, KFF's Larry Levitt probes some of the arguments against it and the policy and political implications of the debate in this New York Times op-ed column.

  • Understanding the Health Provisions in the Inflation Reduction Act

    Other Post

    President Biden signed the Inflation Reduction Act of 2022 into law on August, 16, 2022. KFF has several analyses relevant to understanding the health provisions in the legislation, as well as their potential impact on people. Among other measures, the legislation for the first time requires the HHS Secretary to negotiate prices for some top-selling drugs covered in Medicare. It also requires drug companies to pay rebates if prices rise faster than inflation for drugs…

  • The Virginia Health Care Landscape

    Fact Sheet

    This fact sheet provides an overview of the population health, health coverage, and health care delivery system in Virginia in the era of health reform under the Affordable Care Act (ACA).

  • The Affordable Care Act and Insurance Coverage in Rural Areas

    Issue Brief

    Rural populations face disparities compared to metropolitan populations in health care. While rural individuals were not more likely to be uninsured than metropolitan counterparts pre-Affordable Care Act, they were poorer and less likely to have private insurance. With coverage changes in the ACA involving an expansion of Medicaid for poor and near-poor populations, decisions by states with large rural populations may cause rural residents to have disparate access to coverage, which may exacerbate cost and…

  • Partying Spring Breakers Don’t Represent Most of America’s Young Adults

    Policy Watch

    While news stories accurately depict the actions of some young people on spring break, our latest national poll show they are not representative of young adults more broadly who largely say they are engaging in social distancing practices in response to the coronavirus pandemic.

  • Brief Examines the COVID-19 Crisis’ Implications for Americans’ Mental Health

    News Release

    Nearly half (45%) of adults across the country say that worry and stress related to the coronavirus (COVID-19) pandemic are hurting their mental health, an early sign that the health and economic crises is likely to increase mental health problems and further stretch the system’s capacity. A new issue brief explores how the crises and related measures to protect public health, including social distancing, business and school closures, and shelter-in-place orders, are likely to affect…

  • Health Issues and the Election Quiz

    Feature

    Test your knowledge about health facts, policy issues and proposals that are emerging among the 2020 presidential candidates. The 10 questions focus on health issues in the 2020 election, including: health care costs, prescription drug prices, the Affordable Care Act and changes in health insurance coverage, reproductive health, and Medicare-for-all and public option proposals.

  • At Tax Time, No Public Backlash Over Obamacare’s Individual Mandate

    From Drew Altman

    This was published as a Wall Street Journal Think Tank column on April 21, 2015. Tax season has come and gone with no great outbreak of protest about the Affordable Care Act’s least popular provision: the individual mandate. This central element of the ACA was included to help ensure that the individual insurance market would have balanced pools of healthier people and sicker people to help spread insurance risk and keep premiums reasonable. While most of the…

  • Americans’ Health Priorities Diverge From Washington’s Focus on Obamacare

    News Release

    In his latest column for The Wall Street Journal's Think Tank, Drew Altman finds the public’s health-care priorities have more to do with drug costs and other real-world issues people deal with using the health-care system than the ongoing partisan wrangling over the Affordable Care Act. All previous columns by Drew Altman are available online.