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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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  • A Primer on Medicare Financing

    Issue Brief

    As Congress and the Administration increasingly focus on the nation’s budget deficit, many policy experts and several bipartisan deficit reduction panels have proposed significant changes to Medicare to reduce federal spending and address rising health care costs. This primer provides an overview of Medicare spending trends, how the program is financed, and factors contributing to the growth in Medicare spending. Medicare now covers 47 million seniors and younger people with disabilities, with total expenditures of…

  • Reaching for the Stars: Quality Ratings of Medicare Advantage Plans, 2011

    Issue Brief

    New: Medicare Advantage Plan Star Ratings and Bonus Payments in 2012 In 2012, Medicare Advantage plans will be awarded additional payments based on their quality ratings as a result of the 2010 health reform law. The Centers for Medicare and Medicaid Services has proposed a demonstration that would modify the quality-based payments for plans, providing additional payments for 2012 to 2014. This policy brief by the Kaiser Family Foundation examines the quality ratings of private…

  • Money Follows the Person Transitions Individuals from Nursing Homes to the Community

    Issue Brief

    This brief presents short profiles of four Ohio residents who have benefited from the state's Money Follows the Person demonstration program, known as HOME Choice. It was released along with several other resources on Medicaid long-term services and supports at a Feb. 7, 2011 briefing at the Foundation's Washington, D.C., offices. Profiles (.pdf)

  • A Challenge for States: Assuring Timely Access to Optimal Long-Term Services and Supports in the Community

    Issue Brief

    The Medicaid program is a major payer for long-term services and supports (LTSS) in the United States, accounting for 40 percent of total spending for long-term services and supports. The federal government has played an active role in sponsoring initiatives to promote a shift to community-based care; and evidence from several states suggests that providing care in the community can be less expensive than providing institutional care. The Affordable Care Act (ACA) provides incentives for…

  • New Resources & Briefing Examine Medicaid Long-Term Services and Supports

    Event Date:
    Event

    The following resources by the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU) examine the latest data findings regarding Medicaid’s long-term services and supports for seniors and people with disabilities. The materials were released at a public briefing in the Foundation’s Washington, D.C. offices that featured an expert panel and remarks on long-term services and supports by U.S. Secretary of Health and Human Services Kathleen Sebelius. The reports include: Medicaid Home and Community-Based…

  • Americans Remain Divided Over Health Reform With An Uptick In Public Opposition As GOP Ramped Up Repeal Campaign

    News Release

    As Many Americans Would Like To Keep or Expand Health Reform Law As Would Like To Repeal Or Replace It, And Most Oppose Defunding Implementation Public Concerned About The Deficit But A Majority Opposes Cutting Medicare And Social Security And Nearly Half Are Against Cutting Medicaid WASHINGTON - Though the public remains divided on health reform overall, opposition to the new law ticked upward in January as Republicans ramped up efforts to repeal it, according…

  • KFF/Harvard Survey on Public’s Health Care Agenda for the 112th Congress Finds An Uptick in Public Opposition to Health Reform As GOP Ramped Up Repeal Campaign

    Perspective

    Though the public remains divided on health reform overall, according to a new survey jointly conducted by the Kaiser Family Foundation and Harvard School of Public Health, opposition to the new law ticked upward in January from 41 percent to 50 percent as Republicans ramped up efforts to repeal it. The survey also showed that there is no groundswell of public support for overturning the law, with 47 percent wanting to either expand the law…

  • Boomers Come of Age: Covering Early Retirees and Other 50-64 Year-Olds

    Event Date:
    Event

    The Patient Protection and Affordable Care Act contains provisions that can help workers age 50-64 if they lose their jobs and their employer-sponsored health benefits, such as incentives for employers to maintain retiree benefits. This briefing, cosponsored by the Alliance for Health Reform and AARP, answered many questions about provisions of interests to 50-64 year olds. For more information, please visit Alliance's event page. Speakers for this session: The panel is moderated by Ed Howard…

  • With Federal Support, States Hold Steady in Medicaid and CHIP Coverage Policies for Low-Income Children and Families Despite Recession

    News Release

    New 50-State Survey Finds Some States Make Targeted Expansions to Strengthen Coverage and Achieve Efficiencies as They Prepare for Health Reform WASHINGTON -- Despite tight budgets, nearly all states maintained or made targeted expansions or improvements in their Medicaid and Children’s Health Insurance Programs (CHIP) eligibility and enrollment rules in 2010, preserving the programs’ ability to provide coverage to millions of low-income Americans who otherwise lack affordable options, according to a new survey released today…

  • Pulling It Together: Repeal

    Perspective

    The House will soon vote to repeal the health reform law, the Senate won’t, and the President would veto it if they did.  So what does a House vote for repeal mean? It is, of course, a campaign promise kept to the political right.  It is also a signal from the Republican leadership that they plan to continue to use opposition to the health reform law as a rallying point for their political base.  Our…