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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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  • Kaiser Health Tracking Poll — February 2011

    Feature

    In the wake of the health reform repeal vote in the U.S. House and the ongoing legal challenges over the individual mandate, nearly half the country either believes that the Patient Protection and Affordable Care Act (ACA) has been repealed and is no longer law (22 percent) or doesn’t know enough to say whether it is still law (26 percent). Roughly half of Americans (52 percent) accurately report that the ACA is still the law…

  • Kaiser Health Tracking Poll — February 2010

    Feature

    The February Kaiser Health Tracking Poll finds the public still split on health care reform legislation, with 43 percent in favor and 43 percent opposed. However, the poll also finds that majorities of Americans of all political leanings support several provisions in the health reform proposals in Congress and most attribute delays in passing the legislation to political gamesmanship rather than policy disagreements. The poll finds that at least six of every 10 Republicans, Democrats…

  • Health Affairs Article: Florida’s Medicaid Reform: Informed Consumer Choice?

    Report

    Health Affairs Article: Florida's Medicaid Reform: Informed Consumer Choice? Florida's Medicaid reform program aims to encourage consumer choice and market competition by giving health plans new authority to vary benefits and having enrollees choose among the different plans. However, about three in 10 enrollees were not aware that they needed to make this health plan choice and over half of those who were aware reported difficulty making a plan choice, according to a Health Affairs…

  • Medicaid Financing: An Overview of the Federal Medicaid Matching Rate (FMAP)

    Issue Brief

    Since its enactment in 1965, the Medicaid program has used the Federal Medical Assistance Percentage (FMAP) to determine the federal government's share of the cost of covered services in state Medicaid programs. On average, the federal share has been 57 percent. Beginning in 2014, the Affordable Care Act (ACA) establishes highly enhanced FMAPs for the cost of services to low-income adults with incomes up to 138% of the Federal Poverty Level (FPL) who are not…

  • Health Coverage for the Unemployed

    Issue Brief

    This policy brief outlines the challenges facing the unemployed as they seek to remain insured after losing jobs and employer-sponsored health coverage. In May 2011, 13.9 million people in the U.S. were unemployed. Of these, 6.2 million had been unemployed for six months or more and faced limited options to remain insured. The brief examines potential sources of insurance, including through a spouse's plan, COBRA, the non-group insurance market and public programs. It also discusses…

  • Kaiser Health Tracking Poll — May 2011

    Feature

    Most Americans oppose the idea of converting Medicaid to block grant financing to reduce the federal deficit, and more than half want to see no reductions at all in Medicaid spending. One in five adults has received Medicaid benefits over time, and for most, experiences were positive, although one third of them report having had problems finding a doctor. The findings come at a time of intense public debate in Washington about the future of…

  • Kaiser Health Tracking Poll — August 2010

    Feature

    The August Health Tracking Poll finds that support for health reform fell over the course of August, dipping from a 50 percent favorability rating in July to 43 percent, while 45 percent of the public reported unfavorable views. The dip in favorability returned public opinion on the new law to the even split last seen in May before a modest uptick in support in June and July. Americans’ views of how reform will affect them…

  • Findings of Kaiser Health Tracking Poll: Election 2008 — October 2008

    Poll Finding

    This document contains the key findings from the October Kaiser Health Tracking Poll: Election 2008 poll. The poll involved a nationally representative random sample of 1,217 adults ages 18 and older, including 1,115 adults who say they are registered to vote, who were interviewed by telephone between October 8 and 13, 2008. The margin of sampling error for the full sample is plus or minus 3 percentage points and plus or minus 4 percentage points…

  • How Is The Primary Care Safety Net Faring in Massachusetts? Community Health Centers In The Midst of Health Reform

    Report

    This report examines how community health centers, which provide comprehensive primary care for low-income and uninsured patients, have fared under Massachusetts' health reform law. Community health centers saw a significant increase in patient load amid the state's efforts to improve health coverage by expanding public programs and making private insurance more affordable. That experience shows that community health centers play a critical role in caring for newly insured patients while continuing to serve as the…

  • Voters and Health Reform in the 2008 Presidential Election

    Poll Finding

    This analysis, published in the November 6, 2008, New England Journal of Medicine (NEJM), finds that seven in ten registered voters say major changes are needed in the U.S. health care system. The article is the second in a series of reports published in NEJM examining how the election can provide insights about future health policy. The article examines the public’s perceptions of the state of the American health care system, the role of health…