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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 Will the Uninsured in Pennsylvania Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in Pennsylvania, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Pennsylvania are eligible for Medicaid or financial assistance in…

  • How Will the Uninsured in South Carolina Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in South Carolina, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in South Carolina are eligible for Medicaid or financial…

  • How Will the Uninsured in Utah Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in Utah, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Utah are eligible for Medicaid or financial assistance in…

  • How Will the Uninsured in Washington Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in Washington, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Washington are eligible for Medicaid or financial assistance in…

  • How Will the Uninsured in West Virginia Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in West Virginia, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in West Virginia are eligible for Medicaid or financial…

  • An Introduction to Medicaid and CHIP Eligibility and Enrollment Performance Measures

    Issue Brief

    The Centers for Medicare & Medicaid Services (CMS) recently established 12 new Medicaid and CHIP eligibility and enrollment performance indicators for states to report beginning in October 2013. These indicators provide insight into the performance of new eligibility and enrollment policies established under the Affordable Care Act (ACA). In December 2013, CMS released initial reports for a subset of the indicators. This brief provides an overview of the new performance indicators; the initial data; and…

  • Explaining Health Care Reform: Risk Adjustment, Reinsurance, and Risk Corridors

    Issue Brief

    This brief explains three provisions of the Affordable Care Act (ACA) – risk adjustment, reinsurance, and risk corridors – that were intended to promote insurer competition on the basis of quality and value and promote insurance market stability, particularly in the early years of reform as the ACA marketplaces, also known as exchanges, were established.

  • In Employer Health Insurance Costs, Stability Is the New Normal

    From Drew Altman

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman looks at the sharply slower growth in premiums for employer health benefits and what it might mean for the future of employer-sponsored coverage.

  • The Georgia 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 Georgia and elsewhere across the country. Thousands of Georgians have enrolled in health coverage through the new Health Insurance Marketplace, but Georgia has not implemented the Medicaid expansion, and many low-income adults in the state will likely remain uninsured. This fact sheet provides an overview of the population health, health coverage,…

  • Understanding How States Access the ACA Enhanced Medicaid Match Rates

    Issue Brief

    This brief reviews the rules around the enhanced federal medical assistance percentages (FMAP) provided in the Affordable Care Act (ACA), the process for states to claim the enhanced matching funds and a discussion about what information the new data will provide looking forward.