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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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  • Tracking the Role of Health Care in the 2020 Election: What Do The Polls Tell Us

    Perspective

    In this February 2020 post for The JAMA Health Forum, Mollyann Brodie and Ashley Kirzinger examine the role health care has played in the primary election to date, what the polling data says about the issue, including Medicare-for-all and a public option, and what to expect from the issue during the rest of the 2020 election campaign.

  • Explaining Health Care Reform: What is Health Insurance?

    Issue Brief

    A key element in any comprehensive health reform plan is defining what health insurance is and the amount of insurance coverage people will have. There are two components to that coverage: the types of services covered (e.g., physician care, hospitalization, prescription drugs, etc.), and the cost sharing required of enrollees (e.g., the annual deductible, the copayments or coinsurance, and the maximum out-of-pocket costs for a year). The overall approach to reform drives the kinds of…

  • Pulling it Together: Seniors and Health Reform

    Perspective

    It is widely believed that seniors are antsy about the new health reform law. And there is heightened interest in how seniors feel about the law in the political world because they are more likely to vote in midterm elections.  About 48% of the electorate said they voted in the 2006 midterms while about 63% of seniors said the same.  Our June and July tracking polls shed light on seniors’ views on health reform and…

  • Innovations in Primary Care: What’s in the ACA?

    Event Date:
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    The Patient Protection and Affordable Care Act aims to move the health care system away from an episodic, fee-for-service approach and towards a coordinated, preventive model of care delivery. Exactly how does the law encourage innovations in primary care? What roles will states and purchasers of care play in this transformation? This December 13 briefing, cosponsored the Alliance for Health Reform and The Commonwealth Fund, explored this and related questions. For more information, please visit…

  • Pulling It Together: Uninsured But Not Yet Informed

    Perspective

    If there is one thing there is general agreement on when it comes to the Affordable Care Act (ACA) it’s that it will help the uninsured.  The estimates are that 32 million people will gain coverage under the law through an expansion of Medicaid and tax credits, which will help low- and moderate-income people purchase coverage through the new insurance exchanges. Therefore, it was a real surprise in our latest tracking poll to learn that…

  • Kaiser Analysis: Estimated Health Insurance Rebates Under the Health Reform Law Total $1.3 Billion in 2012

    News Release

    NEWS RELEASEApril 26, 2012 Rebates Expected to Vary Significantly by State MENLO PARK, Calif. – Consumers and businesses are expected to receive an estimated $1.3 billion by this August in rebates from health insurers who spent more on administrative expenses and profits than allowed by the Affordable Care Act (ACA), finds a new analysis from the Kaiser Family Foundation of the latest estimates provided by insurers to state insurance commissioners. The rebates include $541 million…

  • Article and Policy Forum Examine Medicare, Health Reform and the Challenges Facing People With Disabilities

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    Event

    Wednesday, Sept. 8, the Foundation held a policy workshop examining Medicare, health reform and the challenges facing people with disabilities. Younger Medicare beneficiaries with disabilities are much more likely than seniors in the program to report problems accessing and paying for needed medical services, Kaiser Family Foundation researchers report in this Health Affairs article. Based on a national random-sample survey of people on Medicare, the study finds that half of nonelderly disabled beneficiaries report problems…

  • Analysis: ‘Cadillac Tax’ on High-Cost Health Plans Could Affect 1 in 5 Employers in 2022

    News Release

    A new KFF analysis estimates that the Affordable Care Act’s tax on high-cost health plans would affect one in five (21%) employers offering health benefits when it takes effect in 2022 unless employers change their health plans. An even larger share (31%) could be affected when workers’ voluntary contributions to Flexible Spending Accounts are taken into account. The analysis comes as some in Congress are proposing to repeal the ACA’s tax on high-cost health plans,…