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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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  • The American Health Care Act: New House GOP Bill Summary and Interactive Maps of Its Effects on Tax Credits

    News Release

    The Kaiser Family Foundation today issued a summary of the Republican House leadership’s March 6 proposed Affordable Care Act (ACA) replacement bill, the American Health Care Act, that can be compared in 17 key policy areas to the ACA and several other proposed replacement plans. In addition, the Foundation updated its interactive maps that compare county-level estimates of premium tax credits consumers would receive under the Affordable Care Act (ACA) in 2020 with what they’d receive…

  • On Health Care Issues, Voters Give Hillary Clinton a Substantial Edge Over Donald Trump  

    News Release

    Most Americans Worry about Large Number of Zika Cases in U.S. Over Next Year While the public tilts narrowly toward unfavorable views of the Affordable Care Act, presumptive Democratic nominee Hillary Clinton holds a clear advantage on health care issues over presumptive Republican nominee Donald Trump as the 2016 national political conventions approach, and voters generally, including independents, favor Democrats on health issues, the latest Kaiser Health Tracking Poll finds. When asked which of the…

  • JAMA Forum: The Partisan Divide on Health Care

    Perspective

    In this post for JAMA, the Kaiser Family Foundation's Larry Levitt outlines the health care platforms of the Republican and Democratic parties, noting their fundamentally different aims and differing ideas about, among other things, the Affordable Care Act (also known as Obamacare) and Medicare.

  • How ACA Marketplace Premiums Measure Up to Expectations

    Perspective

    Premium increases in the health insurance marketplaces created under the Affordable Care Act (ACA) will likely be higher in 2017 than in recent years; however, the actual average benchmark premium in the ACA marketplaces in 2016 is below what the Congressional Budget Office projected for 2016 before the health law was passed. How actual marketplace premiums compare to what CBO expected in doing those budget projections is an important factor in determining whether the ACA…

  • A Final Look: California’s Previously Uninsured after the ACA’s Third Open Enrollment Period

    Report

    The Kaiser Family Foundation California Longitudinal Panel Survey is a series of surveys that, over time, tracked the experiences and views of a representative, randomly selected sample of Californians who were uninsured prior to the major coverage expansions under the Affordable Care Act (ACA). The initial baseline survey was conducted with a representative sample of 2,001 nonelderly uninsured Californian adults in summer 2013, prior to the ACA’s initial open enrollment period. After each enrollment period…

  • CMS’s Denial of Proposed Changes to Medicaid Expansion in Ohio

    Fact Sheet

    This fact sheet discusses CMS's denial of Ohio's proposed changes to its existing Medicaid expansion . It also provides an overview of the proposed changes as included in the state's Section 1115 demonstration waiver application.

  • The ACA Marketplace Problems in Context (and Why They Don’t Mean Obamacare Is ‘Failing’)

    From Drew Altman

    In this Wall Street Journal Think Tank column, Drew Altman discusses the latest challenges faced by the Affordable Care Act (ACA) marketplaces and why they should be kept in perspective: “If Obamacare had bipartisan support, they would be treated much more like mundane implementation issues to be addressed by Congress than glaring headlines about Obamacare failure.”