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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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  • Children’s Health Coverage: The Role of Medicaid and CHIP and Issues for the Future

    Issue Brief

    This brief summarizes the role Medicaid and CHIP plays in providing coverage to children, discusses the importance of Medicaid and CHIP for children’s health and well-being, provides an overview of the eligibility for coverage of the remaining uninsured children, and raises issues impacting the future of children’s coverage.

  • Two Year Trends in Medicaid and CHIP Enrollment Data: Findings from the CMS Performance Indicator Project

    Issue Brief

    This brief provides an overview of recent trends in Medicaid and CHIP enrollment as of January 2016, based on data from the Centers for Medicare and Medicaid Services (CMS) produced as part of its Performance Indicator Project. The project was designed to provide timely data on Medicaid and CHIP eligibility and enrollment that are intended to help strengthen data-driven program management and oversight efforts at both the national and state level. They also provide insight…

  • Overview of Medicaid Per Capita Cap Proposals

    Issue Brief

    The House Republican Plan (“A Better Way”) released on June 22, 2016, includes a proposal to convert federal Medicaid financing from an open-ended entitlement to a per capita allotment or a block grant (based on a state choice). This proposal is part of a larger package designed to replace the Affordable Care Act (ACA) and reduce federal spending for health care. Often tied to deficit reduction, proposals to convert Medicaid’s financing structure to a per…

  • Medicare Advantage Hospital Networks: How Much Do They Vary?

    Report

    This report takes an in-depth look at Medicare Advantage plans’ hospital networks. The analysis draws upon data from 409 Medicare Advantage plans serving beneficiaries in 20 diverse counties that together accounted for about one in seven (14%) Medicare Advantage enrollees nationwide in 2015. The report examines the size and composition of plans’ hospital networks, the variation across counties, the inclusion of Academic Medical Centers and NCI-Designated Cancer Centers, and the relationship between network size and…

  • 8 Preguntas & Respuestas sobre Puerto Rico

    Fact Sheet

    La crisis de $73 mil millones de Puerto Rico ha sido tema de los medios de comunicación nacionales, y de debate en el Congreso en los últimos meses. Además, varios de los principales medios de prensa han reportado sobre una inminente crisis de la atención de salud relacionada con cuestiones demográficas y del financiamiento del cuidado de salud, y exacerbada por la actual situación económica y el aumento de casos de trasmisión del virus del…

  • Early Analysis of 14 Major Cities Finds Benchmark Silver Plan Premiums in ACA Marketplaces Estimated to Rise 10 Percent on Average in 2017

    News Release

    A Kaiser Family Foundation analysis of Affordable Care Act proposed marketplace rates finds benchmark silver plan premiums are projected to increase 10 percent in 2017 on average across 14 major metropolitan areas. Based on proposed rate filings in 13 states plus the District of Columbia where complete information is currently available, the analysis assesses how premiums for the second lowest-cost silver plan – which is the basis for enrollees’ tax credits -- would change in…

  • ACA Coverage Expansions and Low-Income Workers

    Issue Brief

    This brief highlights low-income workers and the impact of ACA coverage expansions on this population. Low-income workers may not have access to jobs that provide full-time, full-year employment or jobs with comprehensive benefit packages, including health insurance. Medicaid plays an important role in providing health coverage for low-income workers, and coverage expansions implemented under the ACA have produced substantial coverage gains for low-income workers and a corresponding reduction in the uninsured. However, low-income workers in…