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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: What Conservatives Won In Health Reform (And Don’t Seem to Know It)

    Perspective

    Conservatives obviously don't like what they call "Obamacare" because they think it expands the role of government too much and spends too much money.  But ironically, the Affordable Care Act (ACA) actually promotes -- though not explicitly -- something that has been a fundamental objective of conservatives in health care for years: high-deductible health plans with more "skin in the game." In a new study we just released, we commissioned three different actuarial consulting firms…

  • The State of Children’s Health, Care and Coverage

    Event Date:
    Event

    A record 90 percent of children now have health coverage – more than a third of whom are covered by Medicaid and CHIP. Yet about 7.5 million children remain uninsured, including 5 million who are eligible for Medicaid and CHIP but not enrolled. Who are the at-risk kids? How are states faring with enrollment and retention? How will children and families be affected once major parts of the Patient Protection and Affordable Care Act (ACA)…

  • Pulling It Together: A Public Opinion Surprise

    Perspective

    Medicaid is the nation’s primary health insurance program for low-income people and people with disabilities, covering more than 60 million people this year.  And it's about to get a lot of attention: it's likely to be a prime target for spending reductions by "deficit hawks" in debate over the budget; governors are arguing that federal rules requiring them to maintain coverage under Medicaid tie their hands at a time when they are trying to crawl…

  • Kaiser Health Tracking Poll — April 2011

    Feature

    As Congress and the president debate different approaches to reducing the deficit, the April Kaiser Health Tracking Poll indicates that initial public reaction is fairly evenly split when a premium support/voucher program like the one in House Budget Committee Chairman Paul Ryan’s "Path to Prosperity" proposal is described, but seniors prefer to keep the current Medicare system by a 2‐to‐1 margin. Meanwhile, public opinion on the health reform law remains remarkably steady. The April poll…

  • Federal Core Requirements And State Options In Medicaid: Current Policies And Key Issues

    Fact Sheet

    Medicaid is a jointly financed partnership between the federal government and states. The federal-state financing and administrative structure of Medicaid provides a framework of federal core requirements along with broad state options for program design and administration. This issue brief presents an overview of the current Medicaid program framework, with a focus on eligibility, benefits and cost sharing, care delivery and provider payment, long-term services and supports, and dual eligibles, as well as key issues…

  • What the Actuarial Values in the Affordable Care Act Mean

    Issue Brief

    The Patient Protection and Affordable Care Act (PPACA) establishes four levels of coverage based on the concept of "actuarial value," which represents the share of health care expenses the plan covers for a typical group of enrollees. As plans increase in actuarial value – bronze, silver, gold, and platinum – they would cover a greater share of enrollees' medical expenses overall, though the details could vary across plans. The levels of coverage provided for in…

  • Trends in the Use of Hospital and Provider Quality Ratings

    Poll Finding

    With a renewed emphasis on health care quality driven by the Affordable Care Act, this polling data note examines historical trends in Americans' reliance on quality ratings and how their perceptions have changed over time. Data Note (.pdf)

  • The Digital Divide And Access To Health Information Online

    Poll Finding

    The Affordable Care Act (ACA) calls for a number of web-based initiatives, including development of the website healthcare.gov which provides a variety of health information and helps individuals find coverage options. Therefore, understanding the level and quality of Internet access among those groups most likely to benefit from reform, such as the uninsured, those with lower incomes, and members of racial and ethnic minority groups, is an important consideration as health reform is implemented. A…

  • Physician Willingness and Resources to Serve More Medicaid Patients: Perspectives from Primary Care Physicians

    Issue Brief

    This issue brief attempts to assess how primary care physicians will respond to the entry of 32 million newly insured people into the health care system under health reform. The increase in the number of people with health coverage is expected to intensify competition among patients and payers for primary care resources. The brief analyzes data from a nationally representative survey of physicians to assess which adult-care primary care physicians are most likely to respond…

  • Medicaid Policy Options for Meeting the Needs of Adults with Mental Illness under the Affordable Care Act

    Issue Brief

    This paper examines the salient issues raised in a November 2010 roundtable discussion of national and state experts convened by the Kaiser Commission on Medicaid and the Uninsured, in partnership with the Bazelon Center for Mental Health Law, to discuss Medicaid policy options available under health reform to help meet the needs of adults with mental illness. The Patient Protection and Affordable Care Act will expand the Medicaid program, offering the opportunity to improve access…