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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 Other Implication of the CBO Report: Election-Year Pain

    From Drew Altman

    In this Axios column, Drew Altman lays out how the “political pain” from the American Health Care Act would play out over the next two election cycles if passed in its current form, based on the Congressional Budget Office’s analysis of the House-passed bill.

  • Comparison of Medicare Provisions in Recent Bills and Proposals to Repeal and Replace the Affordable Care Act

    Issue Brief

    Repealing and replacing the Affordable Care Act is a top priority of the Trump Administration and the Republican leadership, which could have implications for the Medicare program. This brief provides a side-by-side comparison of the Medicare-related provisions in six bills and proposals that would repeal the ACA, excluding proposals that would not directly affect Medicare.

  • AHCA Quiz Icon

    American Health Care Act (AHCA) Quiz

    Feature

    On May 4, 2017, the US House of Representatives approved the American Health Care Act (AHCA), legislation to repeal and replace the Affordable Care Act (ACA).  On May 24, the Congressional Budget Office scored the latest version of this bill. Do you think you’re an expert on the AHCA?  Take this quiz to test your knowledge.

  • Implications of Reduced Federal Medicaid Funds: How Could States Fill the Funding Gap?

    Issue Brief

    In this analysis, we present three scenarios of reductions in federal Medicaid spending and examine fiscal implications if states fill these financing gaps to maintain their programs and if all reductions are assumed to be in full effect in FFY 2015 (the most recent year for which Medicaid spending data is available). To fill these gaps in financing and maintain current Medicaid programs, we assume states will increase state spending for Medicaid by increasing state…

  • Analysis: 6.3 Million People with Pre-Existing Conditions Would Be at Risk for Higher Premiums under the House’s Health Bill

    News Release

    A new Kaiser Family Foundation analysis estimates that 6.3 million people -- 23 percent of 27.4 million non-elderly adults with a gap of several months in insurance coverage in 2015 – could potentially face higher premiums under the House’s American Health Care Act (AHCA), due to pre-existing health conditions. The bill, which passed the House earlier this month, allows states to waive community rating in the individual insurance market. Insurers in states with such waivers…

  • Gaps in Coverage Among People With Pre-Existing Conditions

    Issue Brief

    The American Health Care Act (AHCA), which has passed the House of Representatives, contains a controversial provision that would allow states to waive community rating in the individual insurance market. In this brief we estimate the number of people with pre-existing conditions who might be affected by such a policy.

  • No, Medicaid Isn’t Broken

    From Drew Altman

    With Medicaid about to be a focal point of debate in the Senate, Drew Altman's Axios column looks at why the idea that the program is broken is more urban legend than fact.

  • Ten Ways That the House American Health Care Act Could Affect Women

    Issue Brief

    In this brief, the Kaiser Family Foundation outlines 10 ways women could be affected under the House of Representatives’ American Health Care Act. In particular, the brief analyzes how changes might affect Medicaid and its expansion population, financial assistance in the individual insurance market, coverage for essential health benefits and preventive services such as contraception, abortion, and maternity care, as well as insurance reforms such as gender rating.