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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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  • Health Issues and the Election Quiz

    Feature

    Test your knowledge about health facts, policy issues and proposals that are emerging among the 2020 presidential candidates. The 10 questions focus on health issues in the 2020 election, including: health care costs, prescription drug prices, the Affordable Care Act and changes in health insurance coverage, reproductive health, and Medicare-for-all and public option proposals.

  • What Iowa and New Hampshire tell us about Medicare-for-All

    From Drew Altman

    In this Axios column, Drew Altman analyzes data from the New Hampshire exit poll showing that support for Medicare-for-all played a role in the primary while broader support for a more moderate plan may be a signal about the general election.

  • Pulling it Together: What Will Health Reform Do For Me?

    Perspective

    There is one poll number that may be more important to watch than any other if we have a big debate about health reform: The percentage of Americans who think that they or their families would be better off if the president and the Congress enacted major health reform legislation. It's a number that signals whether people think that health reform legislation will actually help them with the problems they are having in the current…

  • Health Insurance Exchange Development: Innovation in the States

    Event Date:
    Event

    Under health reform, state-based health insurance exchanges are a mechanism to buy private insurance beginning in 2014. Through panel discussions with state leaders and stakeholders, this briefing, jointly sponsored by the Bipartisan Policy Center (BPC), the Kaiser Family Foundation and the University of Virginia's Batten School of Leadership, explored states’ progress on the exchanges and identified next steps. Agenda (.pdf) Speaker Biographies (.pdf)

  • Kaiser Health Tracking Poll — November 2009

    Poll Finding

    The November Kaiser Health Tracking Poll shows little movement in measures of public opinion about health reform from recent months. Among the new findings is a ranking of the public's top priorities from among a list of elements of the legislation. There were both similarities and differences in priorities across partisan groups: while assuring the availability of affordable plans ranked in the top three priorities for Democrats, Republicans and independents, deficit neutrality ranked in the…

  • Determining Income for Adults Applying for Medicaid and Exchange Coverage Subsidies: How Income Measured With a Prior Tax Return Compares to Current Income at Enrollment

    Issue Brief

    A major goal of the Patient Protection and Affordable Care Act (ACA) is to significantly expand coverage and reduce the number of uninsured. Beginning in 2014, the ACA will establish a new continuum of coverage that will provide assistance to individuals with incomes up to 400% of poverty through a broad expansion in Medicaid and by making premium tax credits available to eligible individuals to purchase coverage through new Health Insurance Exchanges. The law standardizes…

  • The Digital Divide And Access To Health Information Online

    Poll Finding

    The Affordable Care Act (ACA) calls for a number of web-based initiatives, including development of the website healthcare.gov which provides a variety of health information and helps individuals find coverage options. Therefore, understanding the level and quality of Internet access among those groups most likely to benefit from reform, such as the uninsured, those with lower incomes, and members of racial and ethnic minority groups, is an important consideration as health reform is implemented. A…

  • How Competitive Are State Health Insurance Markets?

    Issue Brief

    Beginning in 2014, state-based health insurance exchanges will be created to facilitate coverage and choice, with the hope that enhanced competition among insurers will help to moderate premiums for individuals and small groups. This analysis by the Foundation assesses the competitiveness of state insurance markets for individuals and small businesses to establish a baseline as implementation of the health reform law proceeds and to provide context for the policy decisions states will be considering. The…

  • Report and Video Highlight Health Coverage Struggles, Other Economic Concerns of Working Families

    Event Date:
    Event

    This report and video from the Kaiser Family Foundation's Commission on Medicaid and the Uninsured (KCMU) illustrate the financial struggles of many families in the United States and show the central role of health care costs and coverage in a household's economic stability. The report, Snapshots from the Kitchen Table: Family Budgets and Health Care, is based on interviews with 27 families from six cities across the U.S.. It finds pervasive uncertainty over job security…

  • Massachusetts and Washington: Financial Alignment Demonstrations for Dual Eligible Beneficiaries Compared

    Fact Sheet

    This fact sheet examines the similarities and differences between the five-year demonstrations in Massachusetts and Washington state to integrate care and align financing for people dually eligible for Medicare and Medicaid. The states finalized memoranda of understanding (MOUs) with the Centers for Medicare and Medicaid Services in fall 2012, and the demonstrations in each state are set to begin in April 2013. Fact Sheet (.pdf)