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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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  • Which states offer additional financial assistance for Marketplace plans?

    FAQs

    Ten states currently provide eligible residents subsidies in addition to what the federal government provides for their Marketplace plans: • California • Colorado • Connecticut • Maryland • Massachusetts • New Jersey • New Mexico • New York • Vermont • Washington Check these state Marketplaces for more information. Click here for links to each state's website.

  • Poll: By a Wide Margin, Democratic Voters Now Care More About the Affordable Care Act Than Republican Voters Do, And Voters Trust Democrats More Than Republicans to Handle Its Future

    News Release

    The future of the Affordable Care Act, an issue that was once a key health care issue for Republican voters, is now more important to Democratic voters, a new KFF Health Tracking Poll finds.  About half (49%) of voters say it is a “very important” issue for the candidates to discuss, including more than twice the share of Democratic voters (70%) than Republican voters (32%).  Fielded prior to former President Donald Trump’s recent social media…

  • What Does the Federal Government Spend on Health Care?

    Issue Brief

    As Congressional Republicans and President Trump search for trillions of dollars in cuts to mandatory federal spending that could help offset the cost of extending expiring tax cuts, this brief analyzes current support from the federal government for health programs and services, including both spending and tax subsidies as context for those federal budget discussions.

  • Fraud in Marketplace Enrollment and Eligibility: Five Things to Know

    Issue Brief

    This brief evaluates what is currently known about fraud and abuse in the Affordable Care Act (ACA) Marketplace, including how the final Marketplace Integrity and Affordability Rule and the recently enacted budget reconciliation law change existing Marketplace enrollment and eligibility standards.

  • 5 Key Facts About Medicaid and Veterans

    Issue Brief

    Medicaid helps fill gaps in coverage for veterans who are low-income, have disabilities, or are otherwise ineligible for military health benefits. It supports those with complex health needs and reduces out-of-pocket expenses. This brief presents five key facts about veterans with Medicaid and how policy changes in Congress could affect their coverage and access to care.

  • KFF Health Tracking Poll: ACA Enhanced Subsidies

    Feature

    KFF's Health Tracking Poll looks at public awareness and support for ACA Marketplace subsidies and finds that most adults are unaware the subsidies are set to expire soon. Three in four say Congress should extend the subsidies and support persists despite hearing counter arguments.

  • KFF Health Tracking Poll: Views of the One Big Beautiful Bill

    Feature

    This poll finds two-thirds of the public view the "One Big Beautiful Bill" legislation unfavorably, and its favorability erodes further when people hear about its potential health impacts. As Congress debates changes to Medicaid and the ACA as part of the bill, each program's popularity is at a record high.

  • KFF Health Tracking Poll: The Public’s Views of Funding Reductions to Medicaid

    Feature

    As Congress works to pass the "One Big Beautiful Bill Act," which includes significant changes to Medicaid and the ACA, the latest KFF Health Tracking Poll examines the views of groups that could be most directly impacted by the impending legislation. The poll finds most of the public is worried about the consequences of federal funding reductions to Medicaid, including rural residents, those with lower incomes, and across partisans.