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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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  • Briefing on the ACA in CA: Year One & Beyond

    Event Date:
    Event

    Continuing an effort to explore Affordable Care Act (ACA) implementation in the states, the Kaiser Family Foundation and the Blue Shield of California Foundation examined ACA implementation in California (CA) at a Sacramento, Calif. briefing and panel discussion on May 28. A state official, experts and advocates discussed issues and challenges related to implementation of the law, and the practical impact of providing coverage to roughly 4.5 million Californians who have coverage via the state…

  • How Have Insurers Fared Under the Affordable Care Act?

    Perspective

    This analysis tracks the financial performance of insurers in the individual market by evaluating trends in the medical loss ratio (MLR) in the pre-ACA landscape from 2010 to 2013 and estimates the MLR for the first full year of Affordable Care Act implementation in 2014. Findings suggest that although performance varied among insurers, insurers overall had roughly comparable financial performance in 2014 as in recent prior years.

  • Mapping Pre-existing Conditions across the U.S.

    Issue Brief

    This brief estimates the share of adults with pre-existing conditions by metropolitan and micropolitan statistical area (MMSA), and finds that in some areas, nearly four in ten have so-called declinable medical conditions that could lead to denials of individual insurance coverage based on pre-ACA underwriting guidelines.

  • The Role Health Is and Is Not Playing in the Midterms

    From Drew Altman

    With less than two weeks until Election Day, Drew Altman discusses health being the top issue, but not necessarily the top factor in voters' 2018 decisions. He says the longer-term impact of health may be its continuing role in the debate leading up to the 2020 presidential race.

  • Survey of Non-Group Health Insurance Enrollees

    Report

    Executive Summary January 1, 2014 marked the beginning of several provisions of the Affordable Care Act (ACA) making significant changes to the non-group insurance market, including new rules for insurers regarding who they must cover and what they can charge, along with the opening of new Health Insurance Marketplaces (also known as “Exchanges”) and the availability of premium and cost-sharing subsidies for individuals with low to moderate incomes. Data from the Department of Health and…

  • What Women Think of the Core Issue in the Hobby Lobby Case

    From Drew Altman

    This was published as a Wall Street Journal Think Tank column on June 30, 2014. The Supreme Court decision upholding Hobby Lobby’s ability to refuse to cover certain contraceptive services based on its owners’ religious beliefs has set off a wave of analysis of what the decision means. That will not be resolved anytime soon. But we do know what women think of the policy issue at the core of the case. Overall, by a margin of…

  • The Impact of the Children’s Health Insurance Program (CHIP): What Does the Research Tell Us?

    Issue Brief

    The Children’s Health Insurance Program (CHIP) was established in 1997 to provide coverage for uninsured children who are low-income but above the threshold for Medicaid eligibility. In 2009, and again in the Affordable Care Act (ACA), Congress extended federal funding for CHIP, but funding will expire a little over a year from now. Decisions about CHIP’s future funding will be consequential as more than 8 million low-income children were covered by CHIP at some point…

  • Web Briefing: What Worked, What’s Next? Strategies in Four States Leading ACA Enrollment Efforts

    News Release

    On Monday, July 28 from 1 p.m. to 2:00 p.m. EDT, the Kaiser Family Foundation will hold an interactive web briefing to examine the experiences and lessons of four states - Colorado, Connecticut, Kentucky, and Washington - that each established state-based Marketplaces, expanded their Medicaid programs, and successfully enrolled eligible individuals into Medicaid and Marketplace coverage under the ACA. The briefing will draw upon a new issue brief released today by the Foundation’s Kaiser Commission…