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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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  • Analysis of 2015 Premium Changes in the Affordable Care Act’s Health Insurance Marketplaces

    Issue Brief

    This analysis provides an early look at premium changes for individuals in the health insurance marketplaces, created under the Affordable Care Act (ACA), in major cities across 15 states plus DC. Although premium changes vary across and within states, premium changes for 2015 in general are modest when looking at low-cost plans. On average, individuals will pay slightly less in premiums for the benchmark silver plan in 2015 than in 2014.

  • KFF Health Tracking Poll – May 2020

    Report

    This poll examines people's views on the coronavirus (COVID-19) outbreak as many states begin to re-open their states and the economy, including their expectations, experiences and attitudes about the government responses heading into Summer 2020. It also assesses voters' views ahead of the presidential election in November.

  • Two Medicaid-Related Initiatives That Help Promote Long-Term Care at Home and in the Community, Rather Than in Institutions, Are Set To Expire at the End of December

    News Release

    Two initiatives that for years have helped shift Medicaid enrollees away from nursing homes in favor of long-term care at home and in the community face year-end deadlines that could undercut that trend, according to two new KFF issue briefs. While there does not appear to be substantive disagreement over the initiatives like there is with many other federal health programs, their expiration is coming at a time when Congress is engaged in a contentious…

  • More Than Four in Ten Uninsured Don’t Know Basic Health Insurance Terms, Fewer Understand Complex Coverage Concepts

    News Release

    Kaiser Family Foundation Provides Consumer Resources to Fill Knowledge Gaps as the Second Open Enrollment Period Nears for the Affordable Care Act’s Marketplaces With open enrollment for the Affordable Care Act’s health insurance marketplaces days away, findings from a new Kaiser Family Foundation survey suggest that some people who stand to benefit from the law struggle to understand how coverage works. The survey finds more than four in 10 uninsured people could not correctly identify…

  • Mapping Marketplace Enrollment

    Interactive

    This interactive zip code tool and map displays enrollment in the Health Insurance Marketplaces as a share of the potential market in small geographic areas across the country.

  • Health Insurance Quiz

    Feature

    What is a health insurance premium? Can you describe what an annual health insurance deductible is? Take this 10-question quiz and learn how health insurance literate you are compared to a survey of Americans who were asked the same questions. The language of health insurance can be complex and confusing, particularly for many long-time uninsured people enrolling in the new insurance marketplaces set up under the Affordable Care Act.