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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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  • Navigator Funding Restored in Federal Marketplace States for 2022

    Issue Brief

    This data notereviews the data from CMS about its funding awards to Navigator programs serving consumers in the federal marketplace states during the 2022 open enrollment season, as well as funding trends over time and funding by state.

  • For 3rd Year in a Row, More Insurers are Entering the ACA Marketplaces, Creating More Options for Consumers

    News Release

    For the third straight year, more insurers are entering the Affordable Care Act’s marketplaces and expanding their service areas, creating more options for consumers seeking to buy their own insurance for 2021, a new KFF analysis finds.  The analysis finds 30 insurers joining the marketplace across 20 states, and another 61 insurers are expanding their services within states that they already served. More than a third of counties (1,207, or 38%) will have more insurers…

  • Medicaid Expansion Spending and Enrollment in Context: An Early Look at CMS Claims Data for 2014

    Issue Brief

    This issue brief analyzes spending and enrollment data made available by CMS through the MBES. It breaks out spending and enrollment for the new adult group (Group VIII) that gained coverage in states that adopted the ACA Medicaid expansion. It looks at spending and enrollment for the new adult group in calendar year 2014, putting such data in the context of overall Medicaid spending and enrollment and examines trends across expansion states.

  • Health Insurance Marketplace Calculator Updated for 2016

    News Release

    The Kaiser Family Foundation's Health Insurance Marketplace Calculator is now updated to include local data on 2016 health plans that are being sold through the Affordable Care Act marketplaces. The Spanish-language version of the calculator is also updated.

  • Will GOP Candidates’ Positions on Obamacare Matter in Crowded Field?

    News Release

    In his latest column for The Wall Street Journal's Think Tank, Drew Altman analyzes the politics of Republican Affordable Care Act replacement plans and the challenges all Republican candidates will face distinguishing themselves from others on the ACA in a crowded primary field. All previous columns by Drew Altman are available online.

  • The Affordable Care Act Doesn’t Rank Highly As an Issue for Voters in the Presidential Primaries

    News Release

    Despite Anecdotal Reports about Narrow Networks, 87% of Working-Age Adults with Insurance Are Satisfied With Their Plan's Choice of Doctors; 12% Say They Had to Change Doctors in Past Year As the ACA's Open Enrollment Nears End, Most of Those Who Remain Uninsured Are Disengaged While this month Congress passed and President Obama vetoed legislation to repeal the Affordable Care Act, voters nationally aren't focused on the law in this year's presidential election, the latest…

  • What New Data Tell Us About Doctor Choice

    News Release

    Is choice of doctors eroding? Drew Altman explores the rhetoric versus reality and why the issue resonates with Americans, in his latest column for The Wall Street Journal's Think Tank. All previous columns by Drew Altman are online.