Affordable Care Act

About the ACA

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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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  • How Will the Uninsured in New Hampshire Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in New Hampshire, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in New Hampshire are eligible for Medicaid or financial…

  • How Will the Uninsured in New Jersey Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in New Jersey, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in New Jersey are eligible for Medicaid or financial…

  • How Will the Uninsured in Rhode Island Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in Rhode Island, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Rhode Island are eligible for Medicaid or financial…

  • How Will the Uninsured in Virginia Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in Virginia, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Virginia are eligible for Medicaid or financial assistance in…

  • Data Note: How Many People Have Nongroup Health Insurance?

    Issue Brief

    The implementation of the Affordable Care Act (ACA) has focused attention on the composition of the nongroup market: how it looked before the new regulatory provisions take effect and how it will change afterwards. There are several ways of answering this question, depending on the time period for measuring enrollment and the information source. There is substantial turnover among people with nongroup coverage, which means that the number of people covered at the beginning of…

  • Medical Debt Among People With Health Insurance

    Report

    This report examines the causes and contributors to medical debt, medical bankruptcy, and other difficulties with medical bills among people with insurance. Through in-depth interviews of nearly two-dozen people and quantitative analysis of national survey data, the authors of this report find that in-network and out-of-net-work cost sharing primarily contribute to medical debt among the insured.

  • Implications of Emerging Waivers on Streamlined Medicaid Enrollment and Renewal Processes

    Fact Sheet

    The Affordable Care Act (ACA) significantly modernized and streamlined Medicaid enrollment and renewal processes across all states. Through major investments of time, money, and staff, most states have implemented modernized systems that transformed lengthy, paperwork driven enrollment and renewal procedures to a simplified, technology-driven experience that minimizes burdens on individuals and states. Recently approved and proposed waivers and other proposed policies include new eligibility and enrollment requirements and restrictions that run counter to the ACA’s…

  • Digging Into the Data: What Can We Learn from the State Evaluation of Healthy Indiana (HIP 2.0) Premiums

    Issue Brief

    Indiana initially implemented the ACA’s Medicaid expansion through a Section 1115 waiver in February 2015. Indiana’s waiver included important changes from federal law regarding enrollment and premiums. The initial waiver expired, and Indiana received approval for a waiver extension in February, 2018 which continues most components of HIP 2.0 and adds some new provisions related to enrollment and premiums. This brief looks at available data from the state’s evaluation of premiums prepared by The Lewin…

  • Kaiser Health Tracking Poll – October 2017: Open Enrollment and the ACA Marketplaces

    Poll Finding

    The October Kaiser Health Tracking Poll focuses on the Affordable Care Act’s (ACA) marketplaces as the November 1st open enrollment period approaches, amidst a period of uncertainty on the future of the individual market. The survey finds the majority of the public think it is more important for President Trump and Congress to work on legislation to stabilize the marketplaces rather than continue efforts to repeal and replace the ACA. A majority – across parties…

  • How Premiums Are Changing In 2018

    Issue Brief

    Maps illustrate how premiums in Affordable Care Act (ACA) marketplaces changed for 2018 by looking at the change in the lowest-cost bronze, silver and gold plans by county; counties where an individual’s tax credit covers the full premium of the lowest-cost bronze plan; and counties where the unsubsidized premium for the lowest-cost gold plan has a lower or comparable premium to the lowest-cost silver plan in 2018.