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About the ACA

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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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  • New Kaiser Survey Finds Eleven Million Newly Insured Adults As of Mid-December, But Nearly Half Who Remained Uninsured One Year After Full Implementation of the Affordable Care Act Were Eligible for Medicaid or Marketplace Tax Credits

    News Release

    Many Of The Remaining Uninsured Say They Didn’t Seek Coverage or Considered It Too Expensive, While Others Were Told (Or Believed) They Were Not Eligible About 11 million adults had become newly insured under the Affordable Care Act by mid-December 2014, according to a new national survey of more than 10,000 adults by the Kaiser Family Foundation.  Nearly half of the approximately 30 million adults who remained uninsured were eligible for assistance under the law,…

  • Medicare’s Role in Health-Care Payment Reform

    News Release

    In his latest column for The Wall Street Journal's Think Tank, Drew Altman explores whether Secretary Burwell's announcement this week about Medicare's payment reform initiative is another sign that the public sector is becoming the engine driving payment and delivery reform. All previous columns by Drew Altman are available online.

  • An Overview of New CMS Data on the Number of Adults Enrolled in the ACA Medicaid Expansion

    Issue Brief

    New preliminary data from the Medicaid Budget and Expenditure System (MBES) released by CMS details for the first time the number of adults enrolled in Medicaid under the new Affordable Care Act (ACA) Medicaid expansion category. This issue brief provides an overview of the new data as well as how it differs from the Performance Indicator data.

  • Are Uninsured Adults Who Could Gain Medicaid Coverage Working?

    Fact Sheet

    As additional states consider whether to implement the ACA Medicaid expansion, some have raised pursuing waiver authority to tie Medicaid eligibility for adults under the expansion to work requirements. This fact sheet profiles uninsured adults who could gain Medicaid coverage under the ACA by their relationship to the workforce and job-based coverage.

  • Insurance Markets in a Post-King World

    Perspective

    This perspective addresses how insurance markets might respond if the US Supreme Court sides with the plaintiffs in the King v. Burwell case. The case challenges the legality of premium and cost-sharing subsidies for low- and middle-income people buying insurance in states where the federal government rather than the state is operating the marketplace under the Affordable Care Act (ACA).

  • If Health Insurance Subsidies Are Struck Down, States Will Need Time

    From Drew Altman

    In this column for The Wall Street Journal's Think Tank, Drew Altman explores a practical timetable for state action if the Supreme Court rules in favor of the plaintiffs in King V. Burwell and ponders what Republicans in Congress might do.

  • Facing the Fallout From a King v. Burwell Ruling

    From Drew Altman

    With a Supreme Court decision on King v. Burwell looming, this Drew Altman column for The Wall Street Journal’s Think Tank plays out the politics of a ruling for the two major parties.

  • Poll Finds 62% of Americans Approve of the Supreme Court’s Decision to Continue Allowing ACA Health Insurance Subsidies in All States, While 32% Disapprove

    News Release

    Public’s View of the Health Care Law Remains Nearly Evenly Divided Immediately Following King v. Burwell Ruling Nearly Eight in 10 Americans Expect More Major Battles about the ACA in the Future Just over six in 10 Americans (62%) say they approve of the U.S. Supreme Court’s decision last week to continue allowing low- and moderate-income people in all states to be eligible for government subsidies to buy health plans through Affordable Care Act (ACA)…

  • The Connection Between Health Coverage and Income Security

    From Drew Altman

    In this column in The Wall Street Journal's Think Tank, Drew Altman shows how expanding health coverage and improving economic security for working Americans are connected even though they are often part of separate policy debates.

  • At CMS, the Mission Is Broader Than Medicare and Medicaid

    From Drew Altman

    In his latest column for The Wall Street Journal's Think Tank, Drew Altman discusses whether the Centers for Medicare and Medicaid Services' broad new responsibilities implementing the Affordable Care Act and a more proactive approach to Medicare payment signals that it’s time for (another) name change.