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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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  • Round 3: Legal Challenges to Contraceptive Coverage at SCOTUS

    Issue Brief

    This brief explains how the new regulations issued by the Trump Administration would change the contraceptive coverage requirement for employers and affect women’s coverage, the legal positions for challenging and defending these regulations, the potential rulings, and the broader ramifications.

  • Poll: 4 in 10 Americans Report Losing Their Jobs or Work-Related Income Due to the Coronavirus Crisis, Including More Than Half of Part-Time Workers

    News Release

    Americans, Regardless of Partisan Identity, Prioritize Slowing Coronavirus’ Spread over Restarting the Economy With coronavirus cases rising and businesses shutting down, four in 10 (39%) U.S. residents say they already have lost a job or income due to the crisis, the latest KFF Health Tracking Poll finds. This includes most part-time workers (54%), as well as nearly half of parents with children under age 18 (47%) and those paid hourly or by the job (45%).…

  • Republican Voters Have Moved On from Hating the ACA

    From Drew Altman

    In this Axios column, Drew Altman analyzes KFF’s tracking poll and shows that the ACA is now yesterday’s issue for Republicans. They have shifted their sights to Medicare-for-all...at least for this election season.

  • 2016 Survey of Health Insurance Marketplace Assister Programs and Brokers

    Report

    In its third year, the survey tracks the experiences of assistance programs signing people up for Affordable Care Act coverage during open enrollment and, for consumers who qualify, during special enrollment periods. This year, for the second time, the survey includes health insurance brokers who helped people apply for non-group coverage in an ACA marketplace.

  • Summary of HHS’s Final Rule on Nondiscrimination in Health Programs and Activities

    Issue Brief

    On May 18, 2016, the Department of Health and Human Services (HHS) published a final rule to implement Section 1557 of the Affordable Care Act (ACA), which prohibits discrimination in health coverage and care based on race, color, national origin, age or disability, and, for the first time sex. This Issue Brief provides a technical summary of Section 1557 and the final rule and highlights new protections and provisions included in the law and rule.…

  • pre-existing conditions

    Pre-Existing Condition Prevalence for Individuals and Families

    Issue Brief

    This analysis estimates that almost 54 million people – or 27% of all adults under 65 —have pre-existing health conditions that would likely have made them uninsurable in the individual markets that existed in most states before the Affordable Care Act. Almost half (45%) of non-elderly families include at least one adult with such a pre-existing condition. The analysis also includes estimates by age, state and gender.

  • The Democratic Debates Suffer from a Nasty Case of Plan-itis

    From Drew Altman

    In The Washington Post op-ed “The Democratic Debates Suffer from a Nasty Case of Plan-itis,” Drew Altman says the primary debates are not serving voters well by focusing on details of candidates' health care plans rather than the fundamental differences between them.

  • The Silent Affordability Crisis Facing Sick People

    From Drew Altman

    In this Axios column, Drew Altman shows that employer coverage for lower wage workers is much worse than ACA marketplace coverage for similar populations. It’s a bigger problem we need to talk about more, he says.