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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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  • Key Issues to Consider for Outreach and Enrollment Efforts under Health Reform

    Issue Brief

    The Affordable Care Act will significantly expand health coverage opportunities through an expansion in Medicaid and the creation of new health insurance exchanges in 2014. Effective outreach and enrollment efforts will be vital for assuring the expansions translate into increased coverage. Based on a discussion with federal and state officials and experts, this report identifies key issues to consider with regard to outreach and enrollment under reform. The discussion was part of an ongoing series…

  • A Guide to the Supreme Court’s Review of the 2010 Health Care Reform Law

    Issue Brief

    With the Supreme Court preparing to hear oral arguments about challenges to the 2010 Affordable Care Act in March 2012, this Kaiser Family Foundation brief serves as a primer on the pending case, which challenges the constitutionality both of the law's individual mandate that requires most Americans to obtain health insurance and of provisions requiring states to expand eligibility for their Medicaid programs. The brief provides an overview of the pending case, the key constitutional…

  • January 2012 Kaiser Health Tracking Poll: The ACA and the Supreme Court

    Perspective

    As the Supreme Court prepares to hear legal challenges to the health reform law in March, the latest Kaiser Health Tracking Poll shows that most Americans (59 percent) expect the Justices to base their ruling on their own ideological views rather than their interpretation of the law (28 percent). As for the public’s views on the individual mandate, the poll once again shows that it continues to be unpopular with the public (67 percent unfavorable versus…

  • Betting on Private Insurers

    Perspective

    Just-released estimates of national health spending in 2010 by the Centers for Medicare and Medicaid Services (CMS) show that 45% of our health care spending is financed by the federal and state governments, primarily through the Medicare and Medicaid programs. This share has grown temporarily in recent years because of the economic downturn, as private insurance has declined and Medicaid has grown. It has also increased due to our demographic destiny: the growing cohort of baby…

  • La reforma del cuidado de salud llega al público

    Video

    ¿Esta confundido acerca de cómo la nueva ley de reforma de salud realmente funciona? Este video explica los problemas relacionados con el sistema de salud actual, los cambios que están sucediendo ahora, y los cambios importantes que se anticipan para el 2014.

  • The California Endowment and the Kaiser Family Foundation Release “Health Reform Hits Main Street” Animation in Spanish

    News Release

    Health Reform Explained – En Español  MENLO PARK, Calif. (January 12, 2012) – Today, The California Endowment and the Kaiser Family Foundation are releasing a Spanish-language version of “Health Reform Hits Main Street,” the popular animation that explains the major provisions of the Affordable Care Act. Written and produced by the Kaiser Family Foundation, the Spanish-language version of the animated movie features narration by a partner of The Endowment, Dra. Isabel Gómez-Bassols, psychologist and host…

  • Pulling it Together: 2012: The ACA, and More

    From Drew Altman

    What is remarkable about 2012 (and the current era in health policy) is how many big health policy issues and marketplace changes will be in play at the same time: HEALTH REFORM: There is the implementation of a historic but fragile health reform law, with a Supreme Court decision pending and so much hanging in the balance. MEDICARE AND MEDICAID: There are continuing debates about potentially big changes in Medicare and Medicaid, driven by the…

  • Kaiser Health Tracking Poll — January 2012

    Feature

    As the Supreme Court prepares to hear legal challenges to the health reform law in March, most Americans expect the Justices to base their ruling on their own ideological views rather than their interpretation of the law, according to the January Health Tracking Poll. Other key findings include: The public doubts the Supreme Court renders judgments based solely on the law. Three-quarters (75%) say they think that, in general, Justices let their own ideological views…

  • Health Affairs Article: Medicaid Expansion Under Health Reform May Increase Service Use and Improve Access For Low-Income Adults With Diabetes

    Issue Brief

    This analysis finds that Medicaid’s role in financing diabetes care will grow when many low-income uninsured people with diabetes become eligible for Medicaid as the program expansions under the Affordable Care Act in 2014. Adult Medicaid beneficiaries with diabetes had annual per person health expenditures more than three times higher than adult beneficiaries without the disease -- $14,229 versus $4,568, according to the study. At the same time, many uninsured adults with diabetes are less…

  • Explaining Health Reform: How will the Affordable Care Act affect Small Businesses and their Employees?

    Fact Sheet

    Several provisions of the Affordable Care Act (ACA) will likely have significant effects on small businesses, their employees, and families. Currently, smaller businesses are less likely to offer health insurance coverage to their employees than larger companies: 57% of small businesses with 50 or fewer workers offered health benefits to employees, compared to 92% of businesses with 51 to 100 workers, and 97% of businesses with 101 or more workers in 2011.1  This fact sheet explains…