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Affordable Care Act

About the ACA

Promotional image for KFF video How Affordable is the Affordable Care Act

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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  • Poll: Early Perceptions of House Bill Show Public Thinks It Would Cover Fewer People and Raise Health Costs

    News Release

    Republicans More Likely to Expect Positive Changes Than Democrats or Independents Large Majority Favors Continued Medicaid Funding to Planned Parenthood Fielded March 6-12 as Americans were first learning about the American Health Care Act and before the Congressional Budget Office estimated its effects, the latest Kaiser Tracking Poll shows that large shares of the public expect the House Republican health care plan would result in fewer people having health insurance and higher costs for people…

  • Restructuring Medicaid in the American Health Care Act: Five Key Considerations

    Issue Brief

    On March 9, the House Ways and Means Committee and Energy and Commerce Committee passed the American Health Care Act, the Republican leadership’s plan to repeal and replace the ACA. The Congressional Budget Office estimates that the House bill would reduce federal Medicaid spending by $880 billion over ten years by capping federal Medicaid spending and ending enhanced federal funding for Medicaid expansion adults. By 2026, federal Medicaid spending would be 25% lower than expected…

  • Who Are the 7 Million Nonelderly Adults with Disabilities in Medicaid and What Would the House GOP Bill to Restructure Medicaid Financing and Repeal the Affordable Care Act Mean for Them?

    News Release

    A new brief from the Kaiser Family Foundation explains the role that Medicaid plays for nearly 7 million nonelderly adults with disabilities in the U.S. and explores what the American Health Care Act could mean for their health care and coverage. Medicaid covers more than three in 10 nonelderly adults with disabilities, including people with physical disabilities, such as cerebral palsy, multiple sclerosis, and traumatic brain or spinal cord injuries; intellectual or developmental disabilities such…

  • Primas y créditos impositivos bajo la Ley de Cuidado de Salud Asequible (ACA) vs el American Health Care Act (AHCA): Mapa Interactivo

    Interactive

    Estos mapas comparan los estimados de los créditos impositivos que los consumidores recibirían para pagar las primas en 2020, por condado, bajo la Ley de Cuidado de Salud Asequible (ACA) con lo que recibirían bajo el proyecto de líderes republicanos del Congreso llamado American Health Care Act (AHCA), que se dio a conocer el 6 de marzo.

  • Implications of Reduced Federal Medicaid Funds: How Could States Fill the Funding Gap?

    Issue Brief

    In this analysis, we present three scenarios of reductions in federal Medicaid spending and examine fiscal implications if states fill these financing gaps to maintain their programs and if all reductions are assumed to be in full effect in FFY 2015 (the most recent year for which Medicaid spending data is available). To fill these gaps in financing and maintain current Medicaid programs, we assume states will increase state spending for Medicaid by increasing state…

  • Public Opinion on Women’s Health and Preventive Care

    Feature

    This slideshow draws on findings from a recent Kaiser Health Tracking Poll to provide an in-depth look at public opinion on women's health and preventive care. Results include Americans' awareness and attitudes toward Affordable Care Act provisions for women's health and preventive care, as well as the public's views toward federal funding for Planned Parenthood and reproductive health care for lower income women.

  • Medicaid Restructuring Under the American Health Care Act and Implications for Behavioral Health Care in the US

    Issue Brief

    This brief outlines Medicaid’s role for people with behavioral health conditions and the implications of the American Health Care Act for these enrollees. It includes information on the potential impact of ending the enhanced federal financing for newly eligible adults, removing essential health benefits from state plan amendments, and converting federal Medicaid funding into a per capita cap.