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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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  • “What is CMMI?” and 11 other FAQs about the CMS Innovation Center

    Fact Sheet

    The Center for Medicare and Medicaid Innovation (CMMI), also known as the "Innovation Center," was authorized under the Affordable Care Act with the goals of designing, implementing, and testing new payment and delivery system reform models to address concerns about rising costs, quality of care, and inefficient spending. These FAQs provide an overview of the Innovation Center, as well as details on model performance, beneficiary involvement, and more.

  • Poll: Majority Opposes Hard-Ball Negotiating Tactics to Replace the Affordable Care Act, But Republicans Support It

    News Release

    Somewhat More Want President Trump and Republicans to Continue Working on ACA Repeal and Replace than Want Them to Move onto Other Priorities With President Trump and Congress continuing to discuss repealing and replacing the Affordable Care Act, a majority of the public opposes using hard-ball tactics as a way to force Democrats in Congress to negotiate a replacement, the latest Kaiser Health Tracking Poll finds. President Trump recently suggested that his administration and Congress…

  • State-by-State Estimates of Changes in Federal Spending on Health Care Under the Graham-Cassidy Bill

    Issue Brief

    A new health care bill recently introduced by a number of senators led by Senators Lindsey Graham and Bill Cassidy would repeal major elements of the Affordable Care Act (ACA), make changes to other ACA provisions, and fundamentally alter federal Medicaid financing. In this brief, we estimate changes in federal funding due to the new block grant program and the Medicaid per enrollee cap on a state-by-state basis under the Graham-Cassidy bill relative to current…

  • Medicaid: What We Learned From the Recent Debate and What to Watch for in September 2017

    Issue Brief

    The inclusion of major Medicaid changes in both the American Health Care Act (AHCA) that passed in the House and the Better Care Reconciliation Act (BCRA) considered in the Senate revealed that is hard to gain consensus on significant cuts and reforms to Medicaid. Medicaid has broad general support and intense support from special populations served by the program. In addition, proposed changes would have different implications across states due to significant program variation across…

  • Sizing Up Exchange Market Competition

    Issue Brief

    This issue brief offers an early look into how competitive the health insurance exchanges (also called marketplaces) are under the Affordable Care Act in selected states. Through analysis of enrollment data released by seven states (California, Connecticut, Minnesota, New York, Nevada, Rhode Island, and Washington) this brief finds that exchange markets in California and New York are shaping up to be more competitive than their individual markets were in 2012 while those of Connecticut and…

  • How Buying Insurance Will Change Under Obamacare

    Perspective

    When the Affordable Care Act’s (ACA) health insurance marketplaces (also known as “exchanges”) go online this October, millions of people are expected to apply for private insurance coverage. Nobody expects the launch will be perfect, with no hitches and problems.  The law not only replaces a fragmented and confusing assortment of plan options in today’s individual insurance market, but it also integrates tax credits to help people pay their premiums, which requires an entirely new…