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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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  • Mi empleador ofrece beneficios de salud para mí y mi familia. La compañía paga el costo total de mi cobertura, pero no contribuye al costo de cubrir a mi familia. No podemos solventar la inscripción de...

    FAQs

    Sí, pueden. Las personas que son elegibles para la cobertura patrocinada por el empleador aún pueden calificar para créditos fiscales para las primas del mercado si la cobertura patrocinada por el empleador se considera inasequible. La prueba de asequibilidad analizará el costo de la cobertura individual para usted y el costo de la cobertura familiar para su cónyuge e hijos. Debido a que su empleador paga el 100% de la prima para cubrirlo únicamente a…

  • ¿Qué inmigrantes legalmente presentes califican para la cobertura del mercado?

    FAQs

    Inmigrantes legales generalmente incluyen: residentes permanentes (los que tienen green card o tarjeta verde); personas que huyen de la persecución, incluidos los refugiados y asilados; otros inmigrantes humanitarios; incluyendo aquéllos que tienen un estatus de protección temporal; participantes cubanos o haitianos; sobrevivientes de violencia doméstica, tráfico de personas, y otros crímenes graves; y personas con visas de no inmigrantes válidas, como visas de trabajo o de estudio. La Acción Diferida para los Llegados en la…

  • No tengo seguro. ¿Se requiere que tenga seguro de salud?

    FAQs

    Aunque ya no hay una multa federal por no tener seguro de salud, algunos estados (California, Massachusetts, Nueva Jersey, Rhode Island) y el Distrito de Columbia han adoptado mandatos individuales, con penalidades impositivas estatales si no se tiene seguro de salud. Vermont también tiene un mandato individual pero no impone una penalidad por no tener cobertura. Consulte con su preparador de impuestos para más información o con el departamento de seguros en su estado para…

  • Pre-existing Conditions: What Are They and How Many People Have Them?

    Policy Watch

    Facing a challenge now before the Supreme Court, the Affordable Care Act (ACA) included provisions to protect people with pre-existing conditions from discrimination in the individual employment market. This post explains what pre-existing conditions are and the different estimates for the number of people who have them.

  • How Has the Pandemic Affected Health Coverage in the U.S.?

    Policy Watch

    Findings from administrative data suggest that the decline in enrollment among employer-sponsored insurance was far less than overall declines in employment as of September, and that many who did lose their job-based coverage likely found a safety net in coverage through Medicaid or the ACA marketplaces.

  • pre-existing conditions

    Pre-Existing Condition Prevalence for Individuals and Families

    Issue Brief

    This analysis estimates that almost 54 million people – or 27% of all adults under 65 —have pre-existing health conditions that would likely have made them uninsurable in the individual markets that existed in most states before the Affordable Care Act. Almost half (45%) of non-elderly families include at least one adult with such a pre-existing condition. The analysis also includes estimates by age, state and gender.

  • Poll: 4 in 10 Americans Report Losing Their Jobs or Work-Related Income Due to the Coronavirus Crisis, Including More Than Half of Part-Time Workers

    News Release

    Americans, Regardless of Partisan Identity, Prioritize Slowing Coronavirus’ Spread over Restarting the Economy With coronavirus cases rising and businesses shutting down, four in 10 (39%) U.S. residents say they already have lost a job or income due to the crisis, the latest KFF Health Tracking Poll finds. This includes most part-time workers (54%), as well as nearly half of parents with children under age 18 (47%) and those paid hourly or by the job (45%).…

  • Wisconsin’s BadgerCare Program and the ACA

    Fact Sheet

    This fact sheet provides an overview of changes to BadgerCare, Wisconsin's 1115 waiver demonstration project, and how it relates to the Affordable Care Act's Medicaid expansion.