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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 Insurance Quiz

    Feature

    What is a health insurance premium? Can you describe what an annual health insurance deductible is? Take this 10-question quiz and learn how health insurance literate you are compared to a survey of Americans who were asked the same questions. The language of health insurance can be complex and confusing, particularly for many long-time uninsured people enrolling in the new insurance marketplaces set up under the Affordable Care Act.

  • Assessing Americans’ Familiarity With Health Insurance Terms and Concepts

    Poll Finding

    With the approaching launch of the second open enrollment period for the Affordable Care Act’s (ACA) health insurance marketplaces and at a time when open enrollment is also happening for many job-based plans, the Kaiser Family Foundation conducted a nationally representative survey of 1,292 U.S. adults to shed light on Americans’ understanding of basic health insurance terms and concepts, and to identify gaps in awareness that could lead to difficulties for some individuals as they…

  • Updated FAQs Provide New Answers as the Affordable Care Act’s Marketplace Enters Its Second Year

    News Release

    Today, the Kaiser Family Foundation released an updated collection of Frequently Asked Questions (FAQs) providing detailed answers for consumers, and the navigators and brokers who assist them, as the Nov. 15 start date nears for the Affordable Care Act's second open enrollment period. The searchable collection includes nearly 300 up-to-date responses, answering new questions about plan renewal, cancellations, and continuing financial assistance. The FAQs also offer guidance for understanding 2014 federal income taxes in the…

  • What to Expect From the Next Congress on the ACA

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman explains how Republican control of Congress will likely bring challenges to the Affordable Care Act in two flavors.

  • Explaining the 2015 Open Enrollment Period

    Issue Brief

    The brief provides an overview of what consumers can expect during the second annual Open Enrollment period under the Affordable Care Act (ACA), which runs from November 15, 2014 through February 15, 2015. It is the second opportunity for uninsured individuals to enroll in private insurance coverage, premium tax credits and cost sharing subsidies and the first time that people newly insured in 2014 can renew their health plan coverage and subsidies. It also overlaps…

  • Data Note: Gearing Up For Round 2 of Open Enrollment: Some Lessons From Round 1

    Poll Finding

    As the second round of open enrollment approaches, policy makers, journalists, insurers and enrollment groups may want to keep in mind what health insurance shoppers told us about their experiences during the first open enrollment period. This data note examines selected findings from two Kaiser Family Foundation surveys that shed light on how people navigated the new options and choices available under the ACA during last fall’s open enrollment, with the hope of helping to…

  • How the Midterms Factor Into Medicaid Expansion

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman discusses how Democratic victories in several close gubernatorial races on Tuesday could revive efforts to expand Medicaid.

  • New Analysis Finds the Affordable Care Act Mentioned in 14% of This Year’s Political Ads

    News Release

    Republican Ads Were Much More Likely to Mention ACA, Often in Spots that Also Hit Other Issues About 14 percent of political ads in all races airing this year through October 15 mention the Affordable Care Act, Obamacare or any of the law's specific provisions, mostly in a negative way, a new Kaiser Family Foundation study finds. Overall, about a quarter (26%) of political spots airing so far this year mention health care issues, including…

  • ACA Advertising in 2014 – Insurance and Political Ads

    Report

    This study analyzes the volume and content of political ads mentioning health care issues that aired in 2014 through Oct. 15, as well as health insurance spots promoting specific insurance products or encouraging enrollment in marketplace plans. It finds that about 14 percent of political ads in all races mention the Affordable Care Act, Obamacare or any of the law's specific provisions, mostly in a negative way.

  • Poll: Obamacare Is Not a Big Issue With Midterm Voters

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman analyzes recent polling data on the Affordable Care Act and discusses why it will not be a significant factor in next week’s midterm election.