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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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  • Next Steps for CHIP: What is at Stake for Children?

    Fact Sheet

    The Children’s Health Insurance Program (CHIP) is an important complement to Medicaid, covering 8.4 million children with family incomes above Medicaid eligibility limits who often lack access to affordable private coverage. Following are key facts that highlight what is at stake for children if there is a failure to extend CHIP funding beyond September 2017 and based on changes proposed in the American Health Care Act (AHCA), which would fundamentally restructure Medicaid by capping federal…

  • Factors Affecting States’ Ability to Respond to Federal Medicaid Cuts and Caps: Which States Are Most At Risk?

    Issue Brief

    This issue brief examines the factors that could affect states’ ability to cope with reductions in federal Medicaid funding of the sort proposed in the House-passed American Health Care Act (AHCA), which would eliminate enhanced federal matching funds for the Affordable Care Act’s Medicaid expansion and convert Medicaid to a per capita cap or block grant system of financing.

  • 5 Million More Older Americans Would Become Uninsured under the House GOP Health Bill, and Many with Coverage Would Pay Steep Increases in Premiums 

    News Release

    As a group, older Americans are likely to see some of the biggest changes in their health insurance under the House-passed American Health Care Act (AHCA). The Congressional Budget Office projects that the number of 50- to 64-year-olds who are uninsured would rise to 10 million in 2026, about 5.1 million more than the number who would be uninsured under current law. Many of those who do have coverage would see steep increases in premiums…

  • How ACA Repeal and Replace Proposals Could Affect Coverage and Premiums for Older Adults and Have Spillover Effects for Medicare

    Issue Brief

    This brief explains the key AHCA provisions that would reshape the private market to more closely resemble the pre-Affordable Care Act period, and the effects of these changes on adults ages 50-64. The brief also discusses how changes to Medicaid could affect older, low-income adults, and how an increase in the number of uninsured older adults could have implications for the Medicare program in the future.

  • What Challenges Could State Insurance Markets Face Under the House’s American Health Care Act?

    News Release

    A new brief from the Kaiser Family Foundation outlines options for state insurance markets and challenges that states could face under the House’s replacement for the Affordable Care Act (ACA). Passed by the House on May 4 and now under consideration by the Senate, the American Health Care Act (AHCA) would reduce the federal government’s role and resources in providing health insurance coverage – particularly for people with low or moderate incomes -- while expanding…

  • State Flexibility to Address Health Insurance Challenges under the American Health Care Act, H.R. 1628

    Issue Brief

    The American Health Care Act (AHCA), a bill passed by the House in May 2017 to repeal and replace the Affordable Care Act (ACA), would present states with new authority in individual insurance markets, along with a number of difficult problems and choices and limited resources with which to address them. States would be able to obtain waivers and would be eligible for $123 billion in grant funds, including money from a new Patient and…

  • What’s Really At Stake In the Medicaid Spending Debate

    From Drew Altman

    In this Axios column, Drew Altman highlights that the federal debate about the American Health Care Act’s Medicaid spending reductions will ultimately be a debate about every state’s general budget spending priorities, as states discuss whether to offset reductions in federal revenues with some combination of cuts to their Medicaid programs, increased taxes, and cuts to spending in other areas.

  • Poll: Public Views the ACA More Favorably Than Congress’ Plan to Replace It, Though Republicans Favor the Replacement

    News Release

    Public Grows More Pessimistic About How Repeal Will Affect Them Personally Most (55%) of the public holds an unfavorable view of the Congressional plan that would repeal and replace the Affordable Care Act, and the same share (55%) want the Senate either to make major changes to the House-passed bill or not pass it all, finds the latest Kaiser Health Tracking Poll. Three in 10 (31%) of the public hold favorable views of the American…

  • Kaiser Health Tracking Poll – May 2017: The AHCA’s Proposed Changes to Health Care

    Report

    With House Republicans passing the American Health Care Act (AHCA), their plan to repeal and replace the Affordable Care Act (ACA), and the Senate currently debating the plan and discussing their own approach, the latest tracking poll finds more view the ACA favorably than view the AHCA favorably. The poll examines attitudes towards specific provisions included in the replacement plan and how the public thinks the replacement plan will affect their own health care.