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Affordable Care Act

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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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  • Poll: Most Americans Don’t Realize How Dramatically the Medicare-for-all Proposals Would Revamp the Nation’s Health Care System

    News Release

    As Congress and the Democratic presidential candidates continue to discuss Medicare-for-all and other proposals to expand public health coverage, most Americans know little about how the leading Medicare-for-all proposals would reshape the way all Americans get and pay for health care. This month’s KFF Health Tracking Poll probes the public’s awareness of key elements of proposals to create a national health plan, including the leading Medicare-for-all bills introduced by Sen. Bernie Sanders and Rep. Pramila…

  • Republican Voters Have Moved On from Hating the ACA

    From Drew Altman

    In this Axios column, Drew Altman analyzes KFF’s tracking poll and shows that the ACA is now yesterday’s issue for Republicans. They have shifted their sights to Medicare-for-all...at least for this election season.

  • Poll: On Health Care, Democrats and Democratic-Leaning Independents Trust Sen. Sanders the Most, but Significantly More People Support a Public Option than Medicare-for-All

    News Release

    3 in 4 Americans Do Not Expect Congress to Take Action to Lower Drug Costs Before the 2020 Election Ahead of tonight’s Democratic presidential debate, Sen. Bernie Sanders is the candidate most trusted on health care by Democrats and Democratic-leaning independents, though the Medicare-for-all plan he has championed is significantly less popular than the “public option” approach put forward by some other candidates, the latest KFF Health Tracking Poll finds. Among the overall public, a…

  • Two Medicaid-Related Initiatives That Help Promote Long-Term Care at Home and in the Community, Rather Than in Institutions, Are Set To Expire at the End of December

    News Release

    Two initiatives that for years have helped shift Medicaid enrollees away from nursing homes in favor of long-term care at home and in the community face year-end deadlines that could undercut that trend, according to two new KFF issue briefs. While there does not appear to be substantive disagreement over the initiatives like there is with many other federal health programs, their expiration is coming at a time when Congress is engaged in a contentious…

  • Surprise Bills Often Hit in Emergencies

    From Drew Altman

    In an Axios column, Drew Altman previews new data highlighting that people with critical health issues are especially vulnerable to these bills. 

  • Analysis: 4.7 Million Uninsured People Nationally Could Get a No-Premium Bronze Plan in the ACA Marketplace,Though Deductibles Would be High

    News Release

    As the Affordable Care Act’s open enrollment period nears an end in most areas this week, a new KFF analysis finds that 4.7 million currently uninsured people could get a bronze-level plan for 2020 and pay nothing in premiums after factoring in tax credits, though the deductibles would be high. That works out to 28 percent of the 16.7 million uninsured individuals who are potential customers for coverage through ACA marketplaces. Half of the uninsured…

  • 10 Key Questions on Public Option Proposals

    Issue Brief

    This issue brief presents ten, high-level key questions regarding current public option proposals supported by both Democratic presidential candidates and Members of Congress.

  • Medicaid: What to Watch in 2020

    Issue Brief

    Medicaid, the provider of health insurance coverage for about one in five Americans and the largest payer for long-term care services in the community and nursing homes, continues to be a key part of health policy debates at the federal and state level. Key Medicaid issues to watch in 2020 include: Medicaid expansion developments; Section 1115 waiver activity; enrollment and spending trends; benefits, payment and delivery system reforms, and the implications of the 2020 elections.

  • Sexually Transmitted Infections (STIs): An Overview, Payment, and Coverage

    Fact Sheet

    More people have health insurance than ever before under the Affordable Care Act (ACA), which emphasizes preventive care, including no-cost HIV and STI counseling and screening for recommended populations. This fact sheet examines trends and disparities in STI prevalence, reviews the STI screening and preventive care coverage policies for private insurance and public programs, and discusses coverage gaps and confidentiality concerns in the provision of these services.