Affordable Care Act

About the ACA

Promorional image for KFF video How Affordable is the Affordable Care Actt

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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  • How Will the Uninsured in Vermont Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in Vermont, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Vermont are eligible for Medicaid or financial assistance in…

  • How Will the Uninsured in Hawaii Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in Hawaii, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Hawaii are eligible for Medicaid or financial assistance in…

  • How Will the Uninsured in the District of Columbia Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in District of Columbia, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in District of Columbia are eligible for Medicaid…

  • How Will the Uninsured in North Dakota Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in North Dakota, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in North Dakota are eligible for Medicaid or financial…

  • How Will the Uninsured in Kentucky Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in Kentucky, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Kentucky are eligible for Medicaid or financial assistance in…

  • How Will the Uninsured in Arizona Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in Arizona, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Arizona are eligible for Medicaid or financial assistance in…

  • How Will the Uninsured in Wisconsin Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in Wisconsin, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Wisconsin are eligible for Medicaid or financial assistance in…

  • How Will the Uninsured in New Jersey Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in New Jersey, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in New Jersey are eligible for Medicaid or financial…

  • How Will the Uninsured in Louisiana Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in Louisiana, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Louisiana are eligible for Medicaid or financial assistance in…

  • How Will the Uninsured in North Carolina Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in North Carolina, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in North Carolina are eligible for Medicaid or financial…