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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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  • Large Majorities Favor Wide Range of Policy Changes to Curb Prescription Drug Costs, Including Those That Give Government a Greater Role in Negotiating or Limiting Prices

    News Release

    Amid news reports about increases in the price for EpiPen and other drugs, the vast majority of Americans – including majorities of Democrats, Republicans and independents – support several policy changes to control the cost of prescription drugs, including some that would expand government’s role in drug pricing, the latest Kaiser Family Foundation tracking poll finds. About eight in 10 Americans say they favor allowing the federal government to negotiate with drug companies to get…

  • 10 FAQs: Medicare’s Role in End-of-Life Care

    Fact Sheet

    About eight of 10 of the 2.6 million people who died in the US in 2014 were people on Medicare, making Medicare the largest insurer of health care provided during the last year of life. These Frequently Asked Questions explain Medicare’s role in or coverage of end-of-life care, advance care planning, advance directives, and hospice care. They also provide information on Medicare spending on end-of-life care, changes to the physician fee schedule, and how related issues arose…

  • 8 Questions & Answers about Puerto Rico

    Fact Sheet

    These slides provide a quick snapshot of Puerto Rico’s population, as well as current and upcoming issues that are impacting the island’s health care system.

  • CMS’s Denial of Proposed Changes to Medicaid Expansion in Ohio

    Fact Sheet

    This fact sheet discusses CMS's denial of Ohio's proposed changes to its existing Medicaid expansion . It also provides an overview of the proposed changes as included in the state's Section 1115 demonstration waiver application.

  • Findings from the Field: Medicaid Delivery Systems and Access to Care in Four States in Year Three of the ACA

    Issue Brief

    Based on case studies and focus groups, this brief reviews delivery systems and access to care for Medicaid enrollees in Colorado, Connecticut, Kentucky, and Washington as of Spring 2016. The findings provide an on-the-ground view of Medicaid delivery systems and enrollees’ experiences accessing care three years after implementation of the Medicaid expansion. This brief builds on previous reports that examined states’ preparation for implementation prior to the initial ACA open enrollment period and their experiences…

  • Findings from the Field: Enrollment and Consumer Assistance in Four States in Year Three of the ACA

    Issue Brief

    Based on case studies and focus groups, this brief reviews experiences with Medicaid and Marketplace enrollment, renewal, and consumer assistance in Colorado, Connecticut, Kentucky, and Washington as of Spring 2016. These states implemented the Medicaid expansion and established a state-based Marketplace (SBM) in 2014. This brief builds on previous reports that examined states’ preparation for implementation prior to the initial ACA open enrollment period and their experiences after completion of the first and second open…

  • The Missing Debate Over Rising Health-Care Deductibles

    From Drew Altman

    In this Wall Street Journal Think Tank column, Drew Altman discusses what may be the most important change in the American health system—hint it’s not the Affordable Care Act—which has occurred without much discussion.

  • Medicaid Coverage of Family Planning Benefits: Results from a State Survey

    Report

    This survey of states’ Medicaid family planning policies under fee-for-service finds wide coverage of most prescription contraceptives among 40 states and the District of Columbia (DC), but variable coverage of emergency contraceptives and other family planning-related services. It is the first published report on state coverage of family planning benefits since the passage of the Affordable Care Act (ACA).

  • Kaiser Health Tracking Poll: August 2016

    Feature

    In advance of the 2016 presidential election, the August Kaiser Health Tracking Poll examines what health care issues voters would most like to hear the presidential candidates talk about during their campaigns and which candidate voters trust to do a better job of dealing with certain health care issues. In addition, the August Tracking Poll continues KFF’s analysis on attitudes related to the Zika virus outbreak as well as provides an update on attitudes towards…