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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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  • 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.

  • Health Reform Quiz

    Feature

    Take our short, 10-question quiz to test your knowledge of the law, and then share your results with friends on Twitter or Facebook.

  • 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…

  • Medicare and the Federal Budget: Comparison of Medicare Provisions in Recent Federal Debt and Deficit Reduction Proposals

    Issue Brief

    This brief provides a side-by-side comparison of Medicare provisions included in broad-based packages to reduce the deficit and debt put forward by the President and the Chairmen of the House and Senate Budget Committees. In addition, this brief summarizes Medicare provisions included in other deficit- and debt- reduction proposals released since January 2012 and describes recent activities that pertain to Medicare and the federal budget, including Medicare’s role in the Affordable Care Act (ACA), the…

  • Navigator and In-Person Assistance Programs: A Snapshot of State Programs

    Issue Brief

    With the open enrollment period for health insurance exchanges less than six months away, consumers are already asking questions about their new health care options under the Affordable Care Act (ACA). Even in the age of digital information, hands-on consumer assistance could play a key role in helping people understand their insurance choices come 2014 — a recent Kaiser Family Foundation poll showed that two thirds of the uninsured and a majority of Americans overall…

  • Snapshots: Trends in Employer-Sponsored Health Insurance Offer Rates for Workers in Private Businesses

    Issue Brief

    Most Americans receive their health insurance through their own job or the job of a family member; an offer of coverage at work is an important determinant of the likelihood of having private health insurance. This analysis examines the percentage of nonelderly, full-time adult workers (age 18 through 64) in private firms who were offered health insurance at their current primary job and how that changed over the period from 1995 to 2005. The condition…