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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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  • Health Coverage for the Hispanic Population Today and Under the Affordable Care Act

    Report

    The more than 50 million Hispanics living in the United States make up 17 percent of the total population and are the nation's fastest growing racial or ethnic group. Many Hispanics continue to face disparities in health coverage and care, and they have the highest uninsured rate among racial/ethnic groups, with nearly one in three lacking coverage. This brief provides an overview of the Hispanic population in the U.S., their health coverage today and the…

  • How is the Affordable Care Act Leading to Changes in Medicaid Long-Term Services and Supports (LTSS) Today? State Adoption of Six LTSS Options

    Issue Brief

    Under the Affordable Care Act (ACA), states are afforded a number of new and expanded opportunities, including enhanced federal financing, to improve access to and delivery of Medicaid long-term services and supports (LTSS). This policy brief provides an overview of six key Medicaid LTSS options created or enhanced by the 2010 law and state adoption of these options to date. Nearly every state (47 states and DC) has taken steps forward with at least one…

  • The Affordable Care Act: Three Years Post-Enactment

    Issue Brief

    On March 23, 2010, the Affordable Care Act (ACA) was signed into law. Although the date for full implementation of most provisions of the law is January 1, 2014, the ACA has already led to progress toward expanded coverage of the uninsured; improved access and better care delivery models; broader access to community-based long-term care; and more integrated care and financing for beneficiaries who are dually eligible for Medicare and Medicaid. The brief provides an…

  • Questions for 2014

    From Drew Altman

    Today’s discussion of the Affordable Care Act (ACA) is focused on immediate implementation milestones leading up to 2014 when the law’s major provisions are set to kick in.  This is a critical period when the foundation for the ACA is being established and key building blocks such as the state Medicaid expansions, exchanges, and a host of regulations about other elements of the ACA being produced by HHS are getting our attention. But there is…

  • The Flip Side of Higher Premiums: Better Coverage

    Perspective

    Time Magazine's recent cover story on health care – "Bitter Pill" by Steven Brill – has focused attention on hospital prices, especially for people paying out of their own pockets. This is not a new issue, but certainly one that deserves attention. However, what has been lost in the ensuing commentary on high hospital prices is that Brill’s article is as much about inadequate insurance, which is the reason why the patients he writes about…

  • Kaiser Health Tracking Poll: March 2013

    Feature

    Three years after the passage of the Affordable Care Act, the March 2013 Kaiser Health Tracking Poll finds that a majority of Americans are unsure how the law will impact them, and few are paying attention to the details of state-level decisions about implementation.

  • Market Share of Largest Insurance Carrier in the Individual Insurance Market, 2010

    Feature

    Market Share of Largest Insurance Carrier in the Individual Insurance Market, 2010 Download Source Kaiser Family Foundation analysis of 2010 insurer filings to the National Association of Insurance Commissioners and the California Department of Managed Health Care using the Mark Farrah Associates Health Coverage Portal TM. Market share was calculated as the percent of the state’s individual insurance market enrollment accounted for by each parent company (measured in member months)