Affordable Care Act

About the ACA

Promotional image for KFF video How Affordable is the Affordable Care Act

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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  • Average Individual Mandate Penalty to Rise 47 Percent to $969 in 2016 for Uninsured People Eligible for ACA Plans

    News Release

     3.5 Million Could Have a Zero-Dollar Premium Contribution or Pay Less for Health Insurance than Penalty Due to Premium Subsidies; 7.1 Million Would Pay More to Get Coverage A new analysis from the Kaiser Family Foundation finds that among uninsured people who are eligible for an Affordable Care Act marketplace plan, the average penalty for remaining without coverage in 2016 would be $969 per household – 47 percent higher than the 2015 estimated average of $661.…

  • Few Uninsured Know Date of Pending Deadline for Obtaining Marketplace Coverage; Many Say They Will Get Coverage Soon, Though Cost is a Concern

    News Release

    Most Democrats Like Medicare-for-All, But Very Few Say the Issue Will Drive Their Votes in the 2016 Elections Similar to Last Month, More Hold Unfavorable Views of the ACA than Favorable Ones The Affordable Care Act's third open enrollment period will end on Jan. 31, but the latest Kaiser Health Tracking Poll finds that only a small share of people without health insurance realize it. Just 7 percent of the uninsured correctly identify January as…

  • Bernie Sanders, Hillary Clinton, and Medicare for All

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman explores the differing positions of presidential candidates Hillary Clinton and Bernie Sanders on a single payer or Medicare-for-all health care system and whether Democratic voters consider it an important factor in the 2016 primaries.

  • Bernie Sanders, Hillary Clinton, and Medicare for All

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman explores the differing positions of presidential candidates Hillary Clinton and Bernie Sanders on a single payer or Medicare-for-all health care system and whether Democratic voters consider it an important factor in the 2016 primaries. All previous columns by Drew Altman are online.

  • Surprise Medical Bills

    Issue Brief

    This brief explores the problem of "surprise medical bills" -- charges arising when an insured individual inadvertently receives care from an out-of-network provider. It reviews studies on the extent of the issue, including Kaiser Family Foundation polling data, and outlines state and federal policy responses, including rules and proposed rules for Medicare and plans in Affordable Care Act marketplaces.

  • A Guide to Understanding Medicaid Expansion Waivers as States Debate What to Do Under the ACA

    News Release

    With the recent governors’ elections in Kentucky and Louisiana refocusing attention on state Medicaid expansion decisions, a newly updated issue brief from the Kaiser Family Foundation provides an overview of the waivers obtained by six states – Arkansas, Iowa, Michigan, Indiana, New Hampshire and Montana -- that are pursuing alternative Medicaid expansions under the Affordable Care Act.

  • Two Substantive Sides to Debate Over Obamacare’s ‘Cadillac Tax’

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman says the debate about whether to keep or repeal the Cadillac tax is more than a debate between sound policy and good politics, there are strong substantive arguments on both sides. All previous columns by Drew Altman are available online.

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

    News Release

    In his latest 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. All previous columns by Drew Altman are available online.

  • Analysis Examines How Gaining Health Coverage Affected Consumers’ Lives in 2014

    News Release

    An analysis of a 2014 survey by the Kaiser Family Foundation finds that previously uninsured Americans who obtained health coverage that year experienced improved access to care and a decrease in financial insecurity, though they remained concerned about cost.  The analysis of the 2014 Kaiser Survey of Low-Income Americans and the ACA finds that about 11 million previously uninsured nonelderly adults obtained health coverage during 2014, the year the ACA’s new coverage options were fully…