Affordable Care Act

About the ACA

Promotional image for KFF video How Affordable is the Affordable Care Act

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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  • State Marketplace Profiles: Connecticut

    Other Post

    Final update made on September 27, 2013 (no further updates will be made)  Establishing the Marketplace On July 1, 2011, Governor Dan Malloy (D) signed SB921 (Public Act 11-53) into law establishing the Connecticut Health Insurance Exchange.1   Legislation altering the composition of the Exchange Board passed in June 2012.2 3  In December 2012, the Exchange announced that its new name would be “Access Health CT.” Structure: The legislation defines Connecticut’s Health Insurance Exchange as a quasi-governmental organization, specifically "a…

  • State Exchange Profiles: Florida

    Other Post

    Final update made on December 14, 2012 (no further updates will be made) Establishing the Exchange In December 2012, Governor Rick Scott (R) announced that Florida would not be pursuing efforts to implement a state-based health insurance exchange.1 Governor Scott has been a vocal opponent of federal health reform and the state has refused multiple funding opportunities available through the Affordable Care Act (ACA).2 Florida was also the lead plaintiff in a lawsuit brought by 26 states…

  • Access to Adult Dental Care Gets Renewed Focus in ACA Marketplace Proposal

    Policy Watch

    Adult dental care can lead to high out of pocket costs for consumers, especially for those with private insurance coverage. This post analyzes a proposed provision in the HHS Notice of Benefit and Payment Parameters for 2025, and possible implications for consumers who have Marketplace coverage.

  • The Numbers Behind “Young Invincibles” and the Affordable Care Act

    Perspective

    As enrollment statistics in the new health insurance marketplaces start to become available, there is a growing focus on whether the enrollment of so-called “young invincibles” will be sufficient to keep insurance markets stable. Enrollment of young adults is important, but not as important as conventional wisdom suggests since premiums are still permitted to vary substantially by age. Because of this, a premium “death spiral” is highly unlikely. Why does the age distribution of enrollees…

  • 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,…

  • 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.