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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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  • Puerto Rico: Fast Facts

    Fact Sheet

    Puerto Rico: Fast Facts provides a quick snapshot of the island's demographic, health, and economic characteristics. It also provides some information on federal Medicaid rules, infrastructure, and fiscal challenges ahead.

  • Medicaid Expansion Spending and Enrollment in Context: An Early Look at CMS Claims Data for 2014

    Issue Brief

    This issue brief analyzes spending and enrollment data made available by CMS through the MBES. It breaks out spending and enrollment for the new adult group (Group VIII) that gained coverage in states that adopted the ACA Medicaid expansion. It looks at spending and enrollment for the new adult group in calendar year 2014, putting such data in the context of overall Medicaid spending and enrollment and examines trends across expansion states.

  • Health Insurance Marketplace Calculator Updated for 2016

    News Release

    The Kaiser Family Foundation's Health Insurance Marketplace Calculator is now updated to include local data on 2016 health plans that are being sold through the Affordable Care Act marketplaces. The Spanish-language version of the calculator is also updated.

  • The Affordable Care Act After Six Years

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman examines the role of the Affordable Care Act in the health system on its sixth anniversary, and how the hot debate about the law may have created an exaggerated impression of the good and the bad it can do. All previous Drew Altman columns are online.

  • Contraceptive-Only Plans: Questions and Answers

    Perspective

    In this post on The Huffington Post, Alina Salganicoff and Laurie Sobel offer a Q&A on “contraceptive-only” plans, an approach mentioned during oral arguments in the U.S. Supreme Court case Zubik v. Burwell. In the Zubik case, a group of religiously affiliated nonprofits with religious objections to providing birth control coverage seek an exemption from the Affordable Care Act's provision requiring most plans to offer such coverage without cost-sharing.

  • How Pending Health-Related Lawsuits Could be Impacted by the Incoming Trump Administration

    Issue Brief

    This brief provides an overview of current lawsuits in health policy including preventive services, abortion care, gender affirming care, Medicare drug price negotiations, nursing home staffing rules, private coverage consumer protections, and protections and health coverage for Deferred Action for Childhood Arrivals (DACA) recipients; how they may be affected by the incoming Trump administration; and the implications of their potential outcomes.

  • Compare the Candidates on Health Care Policy

    Feature

    The side-by-side comparison tool provides a quick overview of former President Trump's and Vice President Harris' records, positions, public statements, and proposed policies on a range of key health care topics.

  • ¿Dónde puedo obtener ayuda con mi solicitud del mercado?

    FAQs

    Todos los mercados de seguros deben ofrecer programas de "Navegadores" para ayudar a los consumidores a revisar sus opciones de planes, completar su solicitud de ayuda asistencia financiera, incluyendo ayuda para solicitar Medicaid o CHIP. Los navegadores también pueden ayudar con otros procesos, por ejemplo, cuando el consumidor quiere apelar las decisiones del mercado. Los navegadores reciben su remuneración del mercado, no de los planes de salud, y deben completar la capacitación en el mercado…

  • Soy autónomo y mis ingresos varían de un año a otro. ¿Cómo solicito subsidios para las primas si no sé cuáles serán mis ingresos el próximo año?

    FAQs

    Al solicitar el subsidio para las primas, se le pedirá que calcule sus ingresos esperados para el año siguiente. Un buen punto de partida suele ser considerar sus ingresos de este año o los que declaró en su declaración de impuestos del año anterior. Sin embargo, si sus circunstancias han cambiado desde entonces, debería calcular lo mejor posible sus ingresos para el próximo año. Por ejemplo, si perdió su trabajo recientemente, podría calcular menos ingresos…