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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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  • The Symbolic Manipulation of Health Issues in Elections

    From Drew Altman

    KFF President and CEO Drew Altman explains why data and facts, policy plans and lists of accomplishments do not connect with many voters. Understanding the symbolic dimensions of politics and issues is critical for experts. We can reach a share of the public with facts and data but need additional strategies to reach everyone, including storytelling and trusted messengers.

  • ACA Marketplace Enrollment Is Down By 3 Million After Big Jump in Premium Payments

    Quick Insights

    Enrollment dropped 13% following the expiration of enhanced premium tax credits at the beginning of this year. Enrollment fell from a high of 22.1 million people in 2025 to 19.2 million people in February 2026. While the Trump administration attributes this drop in enrollment to their attempts to address fraud, this coverage loss happened at the same time millions of people faced steep increases in their premium payments – often in the double or even…

  • KFF Examines Challenges in Navigating Coverage for Opill, the First Over-the-Counter Daily Oral Contraceptive Pill, Coming to Market Next Year 

    News Release

    As Opill—the first over-the-counter daily oral contraceptive pill in the United States—is expected to be available for purchase in early 2024, new research conducted by KFF examines barriers to its accessibility for consumers and challenges in providing insurance coverage for it. Based on interviews with nearly 80 representatives from private insurance plans, state Medicaid programs, chain pharmacies, and other key groups, the report provides a deeper view into the operational challenges in expanding access to…

  • Recibí un aviso por correo de la agencia de Medicaid en mi estado sobre la renovación de la cobertura. ¿Qué sigue?

    FAQs

    Complete los formularios requeridos y envíe la información solicitada antes de la fecha límite indicada en el aviso. Si necesita ayuda, los navegadores y otros asistentes en cada estado pueden ayudarlo a completar los formularios, reunir los documentos necesarios y responder otras preguntas. En los estados que usan cuidadodesalud.gov, puede encontrar información de contacto de navegadores y asistentes aquí.

  • How Marketplace Costs and Premiums will Change if Rescue Plan Subsidies Expire

    Policy Watch

    In this Policy Watch we explore the potential impact of the expiration of the American Rescue Plan Act’s enhanced financial help and new eligibility for the Affordable Care Act’s health insurance Marketplace federal subsidies. While the COVID-19 relief legislation passed earlier this year provides greater subsidy assistance through 2022, Democrats in Congress are currently considering making the temporary federal help permanent or extending it as part of their planned budget reconciliation legislation.

  • How Marketplace Costs and Premiums Will Change if American Rescue Plan Subsidies Expire

    News Release

    In a new Policy Watch, KFF analysts explore the potential impact of the expiration of the American Rescue Plan Act’s enhanced financial help and new eligibility for the Affordable Care Act’s health insurance Marketplace federal subsidies. While the COVID-19 relief legislation passed earlier this year provides greater subsidy assistance through 2022, Democrats in Congress are currently considering making the temporary federal help permanent or extending it as part of their planned budget reconciliation legislation. The…

  • I hear there is a special enrollment opportunity for people with very low income. How does that work?

    FAQs

    Starting August 25, 2025, the special enrollment opportunity that allowed individuals with incomes at or below 150% of the federal poverty level to sign up for Marketplace coverage year-round --simply due to their low income --was eliminated. Individuals at this income level might still qualify for special enrollment under other special enrollment events, such as when they lose coverage due to job loss or lose Medicaid coverage.

  • What to Know About the FDA’s Recent Decision to Allow Florida to Import Prescription Drugs from Canada

    Policy Watch

    Florida’s plan to import certain prescription drugs from Canada represents the first time the Food and Drug Administration (FDA) has granted authority for a state to safely import prescription drugs from another country. This policy watch analysis unpacks some frequently asked questions related to state of Florida’s importation plan, including potential obstacles to implementation, who will benefit from any savings, and what types of drugs will (and will not) qualify for importation.

  • Standardized Plans in the Health Care Marketplace: Changing Requirements

    Issue Brief

    This brief examines the evolving requirements for insurers on HealthCare.gov to offer standardized plans that follow set cost sharing rules for covered benefits in addition to other plans they might offer. It also reviews how some state-run marketplaces have used standardized plans to limit cost sharing for insulin, mental health care, and other services.