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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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  • At CMS, the Mission Is Broader Than Medicare and Medicaid

    News Release

    In his latest column for The Wall Street Journal's Think Tank, Drew Altman discusses whether the Centers for Medicare and Medicaid Services' broad new responsibilities implementing the Affordable Care Act and a more proactive approach to Medicare payment signals that it’s time for (another) name change. All previous columns by Drew Altman are available online.

  • How Many Employers Could be Affected by the Cadillac Plan Tax?

    Issue Brief

    As fall approaches, we can expect to hear more about how employers are adapting their health plans for 2016 open enrollments. One topic likely to garner a good deal of attention is how the Affordable Care Act’s high cost plan tax (HCPT), sometimes called the “Cadillac plan” tax or "Cadillac tax," is affecting employer decisions about their health benefits. The tax takes effect in 2018. The potential of facing an HCPT assessment as soon as…

  • Most Say They Can Afford Their Prescription Drugs, But One in Four Say Paying is Difficult, Including More Than Four in Ten People Who are Sick

    News Release

    Large Bipartisan Majorities Support Range of Policy Changes They Believe Would Curb Drug Costs Opinion on the Affordable Care Act Remains Largely Unchanged In August About half of Americans (54%) report currently taking a prescription drug, and a large majority of them (72%) say their prescriptions are very or somewhat easy to afford. However, about a quarter (24%) say paying for their drugs is difficult, and the share facing difficulties rises among those with low…

  • Analysis Estimates 1 in 4 Employers Offering Health Benefits Could Be Affected by the ‘Cadillac Tax’ in 2018 if Current Trends Continue

    News Release

    Share of Potentially-Affected Employers Could Grow to 30% in 2023, 42% in 2028, Analysis Finds New projections from the Kaiser Family Foundation estimate that one in four employers (26%) offering health benefits could be subject to the Affordable Care Act’s tax on high-cost health plans, also known as the "Cadillac plan" tax, in 2018 unless they make changes to their plans. The analysis also estimates that the share of employers potentially affected by the tax…

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

    From Drew Altman

    In this 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.

  • Nearly Half of the Uninsured, or 15.7 Million People, Are Eligible for Medicaid or Subsidized Affordable Care Act Coverage, Analysis Finds

    News Release

    State-Level Numbers Provide Estimates of How Many Could Be Reached During Third ACA Open Enrollment Period Weeks away from the Affordable Care Act’s third open enrollment period, a new Kaiser Family Foundation analysis finds nearly half (49% or 15.7 million) of the 32.3 million nonelderly people in the United States without health insurance at the beginning of 2015 are eligible for Medicaid or subsidized coverage through an ACA marketplace. On a state level, the share…

  • Estimates of Eligibility for ACA Coverage among the Uninsured by Race and Ethnicity

    Issue Brief

    This analysis provides national estimates of eligibility for ACA coverage options by race/ethnicity, including Whites, Blacks, and Hispanics. We estimate coverage and eligibility as of early 2015, which is prior to the end of the 2015 Marketplace open enrollment period. Overall, this analysis finds that more than half (55%) of the total 32.3 million nonelderly uninsured are people of color, including 34% who identify as Hispanic, 14% who identify as Black, and 8% who identify…

  • Prescription Drug Costs Remain Atop the Public’s National Health Care Agenda, Well Ahead of Affordable Care Act Revisions and Repeal

    News Release

    28% of Public Report Asking Doctor about a Drug They Saw Advertised, and 12% Say Their Doctor Prescribed It Few Workers Expect Raises if Employers Reduce Health Benefits to Avoid Cadillac Tax as Many Economists Predict With some presidential candidates laying out details of their health care platforms, the cost of prescription drugs remains at the top of the public's health care priority list for the President and Congress, the October Kaiser Health Tracking Poll…

  • Analysis of Insurer Participation in 2016 Marketplaces

    Issue Brief

    As Marketplace enrollees begin to shop for coverage starting in 2016, the number of insurance choices available to them is changing in some parts of the country.  In early 2015, an average of 6.1 insurer groups offered coverage in each state, up from an average of 5.0 in 2014.  Since then, some insurers have announced their exit or been required to withdraw from the Marketplaces, most notably a number of nonprofit Consumer Operated and Oriented…