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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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  • The Pennsylvania Health Care Landscape

    Fact Sheet

    The Affordable Care Act (ACA) went into full effect on January 1, 2014, ushering in health insurance reforms and new health coverage options in Pennsylvania and elsewhere across the country. Pennsylvania is experiencing changes to its health care delivery system as the state expands Medicaid, provides new coverage options through the federal health insurance marketplace, streamlines application and enrollment processes for coverage programs, and implements new health care delivery system and payment reforms. This fact…

  • Health Insurance Coverage in 2013: Gains in Public Coverage Continue to Offset Loss of Private Insurance

    Issue Brief

    The recession accelerated the long-standing decline in employer-sponsored health insurance and through 2013 most of the recovery in the uninsured rate was due to increased enrollment in public insurance, primarily Medicaid and the Children’s Health Insurance Program (CHIP). With the exception of young adults ages 19 to 25, who are able to remain on their parents’ health plan until age 26 under the ACA, ESI coverage rates for adults and children continued to decrease between…

  • Americans’ Views on the Affordable Care Act Hold Steady, with 43% Now Viewing It Favorably and 42% Unfavorably

    News Release

    Few Report Seeing Comparative Information about Health Care Prices and Quality, and Less Than 10% Use It Pocketbook and Consumer Issues Top Public's List of Priorities for the President and Congress, Ahead of Several ACA-Related Issues This month's Kaiser Health Tracking Poll finds public opinion on the health care law holding steady and closely divided. The share expressing a favorable view (43%) exceeds the share with an unfavorable view (42%) for the first time since…

  • Data Note: How Has the Individual Insurance Market Grown Under the Affordable Care Act?

    Issue Brief

    This data note examines changes in the individual insurance market under the Affordable Care Act. Through analysis of filings by insurers to state insurance departments, the Kaiser Family Foundation estimates that the number of people enrolled in the individual insurance market grew 40 percent from the end-of-year 2013 to the end-of-year 2014 and has likely continued growing in 2015 as well.

  • Evolving Picture of Nine Safety-Net Hospitals: Implications of the ACA and Other Strategies

    Issue Brief

    Safety-net hospitals are an integral part of the U.S. health care landscape, providing care to some of the nation’s most medically vulnerable populations, including Medicaid enrollees and the uninsured. With the implementation of the Affordable Care Act (ACA), the U.S. health care system is rapidly changing, and safety-net hospitals need to make major adjustments to survive in the post-reform environment. This brief draws on interviews with executives at nine safety-net hospital systems and examines how…

  • Safety-Net Emergency Departments: A Look at Current Experiences and Challenges

    Issue Brief

    Safety-net hospital emergency departments (EDs) are an important part of our health care system, especially, but not only, for the uninsured and others with low income. With multiple major changes unfolding in our system today, including the development of new models of health care delivery, payment reforms, expanded insurance coverage, and increasing demand for primary care access, safety-net EDs are a sort of crucible in which these shifts and transitions can be seen playing out.…

  • Kaiser Health Policy News Index: January 2015

    Feature

    The January 2015 Kaiser Health Policy News Index finds fewer than 3 in 10 Americans report paying attention to recent health policy news stories; considerably less than the shares who report following national and international news stories such as tension between the police and the mayor in New York City and the Charlie Hebdo attack in Paris.

  • Majority of Public Says Congress Should Act to Close Gaps if the Supreme Court Bars Financial Help for Purchasing Insurance in States Relying on healthcare.gov; Most in Potentially Affected States Want Their State To Set Up Its Own Marketplace if Needed

    News Release

    Views Mixed on Changes to Definition of Full-Time Work For Employer Mandate, with More Opposed than Supportive, And a Third Saying They Don't Know Enough to Say Public Remains Divided Over Next Steps for the Affordable Care Act, Though Most Expect Major or Minor Changes under GOP Congress this Year Though few Americans are paying attention to the pending Supreme Court case over whether the health care law says that people in all states can…

  • Medicare Spending Peaks at Age 96  

    News Release

    In his latest column for The Wall Street Journal's Think Tank, Drew Altman discusses the implications of a Kaiser finding: per capita Medicare spending peaks at age 96, and the main reason is not end-of-life care. All previous columns by Drew Altman are available online.