Affordable Care Act

About the ACA

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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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  • Pulling It Together: Are We Headed for a Government Takeover of Health Care?

    Perspective

    Remember the “government takeover of the health care system” argument that critics of the health reform law have used?  Well, last week the Office of the Actuary in the Centers for Medicare and Medicaid Services published the latest projections of health spending in the journal Health Affairs.  Attention focused mainly on the Actuary’s estimate that national health spending would grow to almost 20% of GDP by 2020 and that the Affordable Care Act (ACA) would…

  • July Kaiser Health Tracking Poll: Public Still Divided on ACA, Few Believe the Law Will Improve Consumer Protections

    Perspective

    Overall public opinion on the health reform law remains unchanged this month, with 42 percent of Americans holding a favorable view and 43 percent an unfavorable view. Even though previous Health Tracking polls have consistently shown that consumer protections were one of the least controversial and most widely supported provisions of the health reform law, the July poll finds that just one in five Americans think the law will lead to improvements in consumer protections…

  • Health Insurance Exchange Development: Innovation in the States

    Event Date:
    Event

    Under health reform, state-based health insurance exchanges are a mechanism to buy private insurance beginning in 2014. Through panel discussions with state leaders and stakeholders, this briefing, jointly sponsored by the Bipartisan Policy Center (BPC), the Kaiser Family Foundation and the University of Virginia's Batten School of Leadership, explored states’ progress on the exchanges and identified next steps. Agenda (.pdf) Speaker Biographies (.pdf)

  • Remember the People Outside of the Exchanges

    Perspective

    There has been a substantial amount of focus on the recently released draft regulations governing state-based health insurance exchanges under the Affordable Care Act (ACA). And that's appropriate, since the exchanges have the important roles under reform of providing consumers with easier access to insurance and facilitating tax credits and cost-sharing subsidies that make coverage more affordable. But, as central as exchanges will likely be, it's important to remember that there are other key provisions that help…

  • The Innovation Center: How Much Can It Improve Quality and Reduce Costs – and How Quickly?

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    Event

    The new Center for Medicare and Medicaid Innovation (CMMI) seeks to test new health care payment and service delivery models that can potentially enhance quality of care for beneficiaries while reducing costs. How is the agency planning to administer its $10 billion in funding? What early projects is the center undertaking? Is there private sector evidence that its goals can be achieved? What will happen to existing innovations now being rolled out by providers and…

  • Pulling It Together: Writing Regulations

    Perspective

    Not since Geraldo Rivera revealed the secret contents of Al Capone's vault on national TV in the mid-80s, or more recently, sports fans awaited the LeBron James "decision" about where he would play next, have we so anxiously awaited anything as much as the draft health exchange regulations just published by HHS. Well, okay, I exaggerate for effect, but the regulations on health insurance exchanges were anxiously awaited by the health policy community. The hallmark…

  • What is a Mini-Med Plan?

    Perspective

    One of the early insurance market changes in the Affordable Care Act (ACA) phases out caps that some insurance plans impose on the annual dollar amount of benefits they will cover. Plans issued or renewed after September 23, 2010 cannot have annual limits of less than $750,000, and the threshold goes up to $1.25 million in 2011. Annual dollar limits of any kind are prohibited starting in 2014. The federal government has issued waivers from…

  • Kaiser Health Tracking Poll — July 2011

    Feature

    Health care, and particularly Medicare and Medicaid, continue to play a role in the national discussion over the federal budget deficit. In the midst of this debate, the latest Kaiser Health Tracking poll finds that Americans of all political stripes see a role for both spending reductions and tax increases as part of an overall deficit reduction strategy. Still, few are willing to support major spending reductions in Medicare, and a large majority believes the…

  • Explaining Health Reform: Uses of Express Lane Strategies to Promote Participation in Coverage

    Issue Brief

    Under the Patient Protection and Affordable Care Act (ACA), millions of uninsured adults and children will gain eligibility for Medicaid or health coverage through new health insurance Exchanges beginning in 2014. The law calls upon states to develop simple and streamlined processes for establishing, verifying, and updating eligibility for Medicaid, the Children's Health Insurance Program and federal subsidies for Exchange coverage. This issue brief examines how states can employ "express lane" principles in designing systems…

  • Explaining Health Reform: The New Rules for Determining Income Under Medicaid in 2014

    Issue Brief

    To provide individuals and families access to affordable, high-quality health care, the Patient Protection and Affordable Care Act (ACA) expands Medicaid to cover low-income adults and children with incomes up to 133 percent of the poverty line. Millions of low-income parents, non-disabled adults who do not have dependent children (and who are generally ineligible for Medicaid today except in a small number of states) and, in some instances, children now covered through the Children’s Health…