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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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  • Kaiser Health Tracking Poll: June 2014

    Feature

    As many employers begin to expand their wellness programs under new guidelines set forth by the Affordable Care Act (ACA), the latest Kaiser Health Tracking Poll finds workers oppose programs that make them pay higher premiums if they fail to participate or meet specific health goals. Overall public opinion of the ACA remains about the same as it has for the last several months, with a somewhat higher share of the public continuing to express…

  • Kaiser Health Policy News Index: June 2014

    Feature

    This month's Health Policy News Index finds more than six in 10 say they followed news about long waiting lists for those seeking care at Veterans Affairs (VA) medical facilities closely. That makes the VA story the most closely followed health story in the first half of 2014, with slightly more people following it than followed several ACA enrollment stories earlier this year.

  • What Women Think of the Core Issue in the Hobby Lobby Case

    From Drew Altman

    This was published as a Wall Street Journal Think Tank column on June 30, 2014. The Supreme Court decision upholding Hobby Lobby’s ability to refuse to cover certain contraceptive services based on its owners’ religious beliefs has set off a wave of analysis of what the decision means. That will not be resolved anytime soon. But we do know what women think of the policy issue at the core of the case. Overall, by a margin of…

  • Legal Analysis of the Supreme Court Ruling on Hobby Lobby

    Feature

    This chart looks at the U.S. Supreme Court decision in the Hobby Lobby case involving the Affordable Care Act's (ACA) contraceptive coverage requirement. It examines how the Court answered four key questions in the case.

  • On Medicaid Expansion, Red States Will Be Watching Red States

    From Drew Altman

    This was published as a Wall Street Journal Think Tank column on June 30, 2014. Since the Supreme Court made expanding Medicaid optional for states under the Affordable Care Act, 26 states have expanded Medicaid. Three of the 24 states that have not–Indiana, Utah and Pennsylvania–are considering expanding via federal waivers that they are negotiating with the Obama administration. In Virginia, the newly elected Democratic governor is looking for a way around opposition from the Republican-controlled legislature,…

  • Visualizing Health Policy: Understanding the Effect of Medicaid Expansion Decisions in the South

    Other Post

    This Visualizing Health Policy infographic examines the effect of decisions by states in the South to implement or forgo the Affordable Care Act Medicaid expansion. It shows that Southerners are more likely than people living in other parts of the United States to be uninsured; that most Southern states have poverty rates above the national average; that without the Medicaid expansion (which most Southern states are not implementing), Medicaid eligibility levels for adults in the South remain…

  • Visualizing Health Policy: Understanding the Effect of Medicaid Expansion in the South

    News Release

    This Visualizing Health Policy infographic examines the effect of decisions by states in the South to implement or forgo the Affordable Care Act Medicaid expansion. It shows that Southerners are more likely than people living in other parts of the United States to be uninsured; that most Southern states have poverty rates above the national average; that without the Medicaid expansion (which most Southern states are not implementing), Medicaid eligibility levels for adults in the…

  • Data Note: Differences In Public Opinion On The ACA’s Contraceptive Coverage Requirement, By Gender, Religion, And Political Party

    Feature

    One of the most politically polarizing elements of the Affordable Care Act (ACA) is the law’s requirement that new private health insurance plans cover prescription contraceptives and services, including all methods approved by the Food and Drug Administration. The rule currently provides an exemption for houses of worship and an “accommodation” for religiously affiliated non-profit employers who object to providing contraceptive coverage; however all for-profit employers that provide health insurance must include this benefit. Over…

  • Health Coverage and Care in the South in 2014 and Beyond

    Issue Brief

    This issue brief provides an overview of health coverage and care in the South today, with a focus on demographics, the impact of the ACA coverage expansions, and ongoing efforts to improve the delivery system and safety net in the South.