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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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  • Preventive Services Use Among People with Private Insurance Coverage

    Issue Brief

    This analysis of claims data estimates that six in ten people with private health insurance - or about 100 million people - used at least one preventive service covered without any out-of-pocket costs through a provision of the Affordable Care Act (ACA) in a typical year prior to the COVID-19 pandemic (2018). The provision that requires most private health plans to cover many preventive services without any cost-sharing for their enrollees is being challenged in…

  • Si no he declarado impuestos el año anterior, ¿cómo determinará el mercado de seguros de salud mis ingresos?

    FAQs

    Si un solicitante no presentó impuestos en un año anterior, el mercado de seguros de salud verificará los ingresos mediante el uso de datos salariales electrónicos. Si la información no se puede verificar electrónicamente, se le puede pedir al solicitante que presente documentación impresa adicional dentro de los 90 días, como recibos de pago, un contrato de trabajo u otra verificación de ingresos. A partir del próximo año, si no ha presentado impuestos federales sobre…

  • ¿Qué es el Formulario 8962?

    FAQs

    El formulario 8962 es un formulario que debe presentar con su declaración de impuestos federal durante un año si recibió un crédito fiscal para pagar las primas por adelantado a través del mercado de seguros de salud durante ese año. En la inscripción abierta, cuando solicita un crédito fiscal para la prima para el próximo año, el monto de su crédito fiscal adelantado se basa en su ingreso estimado para el próximo año. Al año…

  • KFF Health Tracking Poll May 2024: Voters’ Views of Health Policy Issues in Context of Presidential Campaigns

    Feature

    Voters are split largely along partisan lines in terms of who they trust in regard to various health care issues, but Biden captures more than Trump trust from Independent voters. Biden is also more trusted by older adults when it comes to entitlement programs. Voters are still largely unaware of the drug pricing provisions of the Inflation reduction Act. Large majorities of voters, particularly Democratic voters, support a federal right to abortion.

  • New KFF Poll Finds that Many Older Voters Are Unaware of Medicare Drug Price Negotiation, But Awareness Has Grown

    News Release

    A new KFF poll finds that many older voters are unaware of the provision in the Inflation Reduction Act that for the first time requires the federal government to negotiate the price of some prescription drugs in the Medicare program, a key campaign issue for President Joe Biden. The 48% of voters ages 65 and older who are aware of the landmark change represents a 12 percentage point increase from November, the poll shows.  Fifty-two…

  • Children’s Health Coverage: Medicaid, CHIP and the ACA

    Issue Brief

    This brief provides an overview of children’s coverage leading up to the implementation of the Affordable Care Act (ACA), a review of changes for children included in the ACA, and a look at issues leading up to the reauthorization of the CHIP program.

  • Obamacare: The Metrics In The News Are Mostly Wrong

    From Drew Altman

    In this Policy Insights, Kaiser Family Foundation President and CEO Drew Altman explains how the measures of success for year one of Obamacare used in media coverage and national discussion is the equivalent of judging the local weather from national averages.

  • Kaiser Health Tracking Poll: March 2014

    Feature

    The March Kaiser Health Tracking Poll finds that the gap between unfavorable and favorable opinions of the ACA narrowed this month among the public and the uninsured, and more want Congress to improve the law than replace it. The survey also finds that six in ten of the uninsured are unaware of the March 31 deadline to sign up for coverage, and half say they plan to remain uninsured.

  • A Tale of Two Siblings, the ACA, and the Supreme Court

    From Drew Altman

    In a column published on The Huffington Post, Kaiser Family Foundation President and CEO Drew Altman shows how the U.S. Supreme Court’s decision to make the ACA Medicaid expansion a state option has upended the health insurance system for low and moderate income people in many states and discusses how the states and federal government can address the problem.