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About the ACA

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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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  • Snapshots: Trends in Employer-Sponsored Health Insurance Offer Rates for Workers in Private Businesses

    Issue Brief

    Most Americans receive their health insurance through their own job or the job of a family member; an offer of coverage at work is an important determinant of the likelihood of having private health insurance. This analysis examines the percentage of nonelderly, full-time adult workers (age 18 through 64) in private firms who were offered health insurance at their current primary job and how that changed over the period from 1995 to 2005. The condition…

  • Snapshots: Comparison of Expenditures in Nongroup and Employer-Sponsored Insurance: 2004-2007

    Issue Brief

    Data from the insurance industry and reviews of premiums offered through on-line sellers show that premiums for nongroup health insurance are lower than premiums reported on national surveys for employer-sponsored health insurance (ESI).  This paper uses pooled data from the 2004 through 2007 Medical Expenditure Panel Survey to compare the insurance payments for and out-of-pocket payments by people with nongroup health insurance and people with ESI.  While premiums for non-group coverage are lower than ESI…

  • A Profile of Health Insurance Exchange Enrollees

    Report

    The Patient Protection and Affordable Care Act calls for the creation of Health Insurance Exchanges in all states by January 1, 2014. The exchanges are a critical element of the health reform law, aimed at helping individuals and families shop for and purchase health insurance on their own with additional assistance for lower-income individuals and families. The Congressional Budget Office has estimated that approximately 24 million people will purchase coverage through the state health exchanges…

  • Transitioning Beneficiaries with Complex Care Needs to Medicaid Managed Care: Insights from California

    Issue Brief

    This brief examines how health service providers, plan administrators, and community-based organizations in Contra Costa, Kern, and Los Angeles Counties experienced the transition of Medi-Cal-only seniors and persons with disabilities (SPDs) to managed care as part of the state’s “Bridge to Reform” Medicaid waiver. Findings presented may inform similar transitions of high-need beneficiaries in other states and coverage expansions in 2014 under the Affordable Care Act.

  • California’s Health Care Environment and Health Reform Efforts: June 2013 Update

    Issue Brief

    This brief provides and update of the health care and health policy environment in California, discussing the budgetary environment, implementation of the state's "Bridge to Reform" Medicaid waiver, and efforts to prepare for coverage expansions and new coverage options in 2014 under the Affordable Care Act.

  • Medicaid Expansion through Premium Assistance: Key Issues for Beneficiaries in Arkansas’ Section 1115 Demonstration Waiver Proposal

    Issue Brief

    This issue brief provides background about Medicaid premium assistance in the individual health insurance market, summarizes major components of Arkansas’ Section 1115 demonstration waiver application to implement the Affordable Care Act’s Medicaid expansion through premium assistance, and considers key issues affecting beneficiaries.

  • A Discussion with Leading Medicaid Directors: As FY 2013 Ends, Looking toward Health Care Reform Implementation in 2014

    Issue Brief

    The Kaiser Commission on Medicaid and the Uninsured convened a focus group discussion with Medicaid directors who serve on the Board of the National Association of Medicaid Directors (NAMD). The discussion focused on state progress and concerns about implementing the ACA including eligibility system changes and state action on the Medicaid expansion decision as well as activity around payment and delivery system reform, and other budget and enrollment trends. The discussion took place in May…

  • Health Coverage for the Black Population Today and Under the Affordable Care Act

    Fact Sheet

    The Affordable Care Act (ACA) could help many uninsured Blacks through the law’s expansion of Medicaid and the creation of new health insurance exchange marketplaces with tax credits to help moderate-income people purchase coverage. This brief provides an overview of the Black population in the U.S., their health coverage today and the potential impact of the ACA coverage expansions.