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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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  • 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…

  • GOP Views of Medicaid Expansion Differ From Conventional Wisdom

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman examines Republican attitudes on Medicaid expansion in light of last night’s election of Republican Matt Bevin as Kentucky’s next governor. All previous columns by Drew Altman are available online.  

  • The Role of Language in Health Care Access and Utilization for Insured Hispanic Adults

    Issue Brief

    The ACA coverage expansions may help mitigate some barriers people with limited English proficiency (LEP) face in accessing coverage and care. However, individuals with LEP may still face increased barriers to care with coverage. This analysis examines differences in health care experiences between English- and Spanish-speaking Hispanic adults with insurance using data from the 2014 Kaiser Survey of Low-Income Americans and the ACA.

  • Health Care and the 2016 Debates

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman discusses the lack of attention to health in the primary debates and last week's Democratic forum in South Carolina.