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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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  • Amid Tensions, Legal Immigrants Fear Signing Up for Obamacare

    From Drew Altman

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman discusses new Kaiser Family Foundation survey findings about how fear of enforcement of immigration laws may be affecting Latino enrollment in the Affordable Care Act.

  • How Obamacare Is Doing Better But Feeling Worse

    From Drew Altman

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman explains why even as there are recent positive indicators of the Affordable Care Act’s performance and impact, public opinion about the law has not changed since passage of the law.

  • Sen. Mark Pryor Spotlights the Health Law’s Rx for Pre-Existing Illnesses

    From Drew Altman

    In a column for The Wall Street Journal’s Think Tank, Drew Altman explains why Senator Mark Pryor’s new campaign ad features the Affordable Care Act’s protections for people with pre-existing medical conditions, the somewhat forgotten “mega provision” of the law.

  • An Overview of Medicaid Incentives for the Prevention of Chronic Diseases (MIPCD) Grants

    Issue Brief

    This brief provides an overview of the Medicaid Incentives for the Prevention of Chronic Diseases (MIPCD) grants and highlights key findings from the interim evaluation of the program. The brief also places these grants in context of pre-Affordable Care Act (ACA) Medicaid beneficiary incentive programs and proposed programs of states that are incorporating healthy behavior incentives into Medicaid expansion waivers.

  • Majority of the Public Say They Haven’t Been Affected By the Health Reform Law

    News Release

    Democrats More Likely to Say They Have Been Helped By the Law, Republicans More Likely to Say They Have Been Hurt Republican Voters Want ACA Debate to Continue, Democrats Would Rather Hear Candidates Talk About Issues Like Jobs, Independents Are More Split More than four years after the Affordable Care Act's enactment and more than a month after the close of open enrollment, six in 10 Americans (60%) say the health reform law has not…

  • Medicaid Enrollment: An Overview of the CMS April 2014 Update

    Fact Sheet

    CMS recently released its latest update on Medicaid and CHIP enrollment data, covering the period through April 2014. This fact sheet provides a brief overview of the latest data and what it suggests about the impact of the ACA on Medicaid and CHIP enrollment, providing historical trends for context

  • The Utah Health Care Landscape

    Fact Sheet

    This fact sheet provides an overview of the population health, health coverage, and health care delivery in Utah in the era of health reform.

  • How Much Financial Assistance Are People Receiving Under the Affordable Care Act?

    Issue Brief

    This analysis examines the amount of financial assistance that people have qualified for through premium tax credits in the new health insurance marketplaces (also known as exchanges) under the Affordable Care Act through the end of February 2014. The brief also examines the implications that the enrollment variation carries for the potential tax benefits the Affordable Care Act offers to state residents.