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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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  • Visualizing Health Policy: Eligibility and Coverage Trends in Employer-Sponsored Health Insurance

    News Release

    This Visualizing Health Policy infographic looks at eligibility and coverage trends in employer-sponsored health insurance. Between 2000 and 2015, the share of workers covered by health benefits offered by their employers dropped from 63 percent to 56 percent, with some firms not offering coverage and some employees not enrolling when coverage is offered. The biggest decrease occurred among employees working for small firms (3-199 workers). Among people younger than 65, those with lower incomes continued to…

  • Clinton-Sanders Contest Fuels Democratic Support for Expanding Obamacare

    From Drew Altman

    In this column for The Wall Street Journal's Think Tank, Drew Altman discusses how the debate between Hillary Clinton and Bernie Sanders about how to get to universal coverage has generated more support among Democrats for expanding the Affordable Care Act (and less support for the law as is).

  • Aprenda sobre seguros médicos: los videos en español

    Video

    The YouToons help consumers understand health insurance by explaining health insurance premiums, out-of-pocket costs, and provider networks. These three videos are excerpts from the 2014 YouToons video, Health Insurance Explained – The YouToons Have It Covered.

  • Survey of Non-Group Health Insurance Enrollees, Wave 3

    Poll Finding

    The survey, conducted shortly after the close of the Affordable Care Act’s third open enrollment period, is the third in a series exploring the experiences of individuals who purchase their own health insurance in the nongroup market, including coverage purchased both inside and outside the ACA’s marketplaces. It examines enrollees’ satisfaction with their health plans’ premiums, deductibles, and provider networks, their views on affordability, shopping experiences, and problems encountered with their plans.

  • Survey Finds Most Marketplace Enrollees Like Their Coverage, Though Satisfaction with Premiums and Deductibles Has Declined Since 2014

    News Release

    Following the Affordable Care Act’s (ACA) third open enrollment period, a new Kaiser Family Foundation survey of people who buy their own health insurance finds most marketplace enrollees give their coverage good marks, though concerns about premiums, deductibles, and other costs have risen since 2014. The survey, the third in a series, finds about two thirds (68%) of marketplace customers rate their current coverage as either “excellent” or “good.” Although concerns about narrow network plans…

  • Campaign 2016: Voters Give Clinton Wide Edge Over Trump on Trust to Handle Health Care Issues; ACA Ranks Lower Among Health Issues Voters Want Discussed

    News Release

    Electronic Medical Records: Eight in 10 Americans Say It Is Important for Providers to Computerize Records, But Half Worry About Unauthorized Access to Online Information With the 2016 elections just 10 weeks away, voters give Democratic presidential nominee Hillary Clinton a substantial advantage over Republican nominee Donald Trump on a wide array of health care issues, the latest Kaiser Health Tracking Poll finds. Two thirds of voters (66%), including large shares of Democrats, Republicans, and…

  • The Missing Debate Over Rising Health-Care Deductibles

    From Drew Altman

    In this Wall Street Journal Think Tank column, Drew Altman discusses what may be the most important change in the American health system—hint it’s not the Affordable Care Act—which has occurred without much discussion.