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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: Implementation Is Forever

    Perspective

    Now that historic health reform legislation is law, everyone is rightfully focused on implementation. There are two very different ways to look at implementation. One is the more legalistic worm's eye view, which sees implementation largely as the process of putting into effect what was written in the law. In the worm's eye view implementation proceeds in a linear fashion from legislation, to regulations specifying what the statute calls for in greater detail, to operations…

  • Kaiser Health Tracking Poll — April 2010

    Feature

    The first Kaiser Health Tracking Poll fielded since the passage of health reform last month finds that 8 in 10 Americans know that President Obama signed the legislation into law. But 55 percent say they are confused about the law and more than half (56%) say they don’t yet have enough information to understand how it will affect them personally. The poll finds that the public supports many of the provisions of health reform that…

  • Explaining Health Care Reform: Questions About Health Insurance Exchanges

    Issue Brief

    The Patient Protection and Affordable Care Act (PPACA), signed into law in March 2010, made broad changes to the way health insurance will be provided and paid for in the United States. PPACA created a new mechanism for purchasing coverage called Exchanges, which are entities that will be set up in states to create a more organized and competitive market for health insurance by offering a choice of health plans, establishing common rules regarding the…

  • Medicaid Beneficiaries and Access to Care

    Fact Sheet

    The health reform law relies on a large expansion of Medicaid to reach many low-income uninsured people, many of them adults. This fact sheet summarizes Medicaid beneficiaries' experience in obtaining access to care, a subject that is of keen interest in view of the planned expansion of the program. Medicaid and the Children's Health Insurance Program have substantially increased coverage among low-income Americans, especially children. Research shows that Medicaid compares favorably with private coverage in…

  • Kaiser Health Tracking Poll — March 2010

    Feature

    The March Kaiser Health Tracking Poll finds the public still divided on health reform legislation, with 46 percent of Americans backing the reform proposals on Capitol Hill, 42 percent opposing them and 12 percent saying they aren't sure. Six in 10 Americans say they have heard little or nothing about budget reconciliation. And many people continue to struggle with health costs, with nearly one in five saying cost increases have caused them or their employer…

  • Pulling it Together: When Premiums Go Up 39%

    Perspective

    Our group that works on health care cost issues just updated an analysis that sheds light on what’s really happening to people in the individual health insurance market, the issue Secretary Sebelius, a former Kansas insurance commissioner, and others have put in the spotlight by calling on Anthem and other insurance companies to account for their proposed high premium increases. The analysis shows that people buying health insurance on their own in the individual market…

  • Snapshots: Comparison of Expenditures in Nongroup and Employer-Sponsored Insurance: 2004-2007

    Issue Brief

    Data from the insurance industry and reviews of premiums offered through on-line sellers show that premiums for nongroup health insurance are lower than premiums reported on national surveys for employer-sponsored health insurance (ESI).  This paper uses pooled data from the 2004 through 2007 Medical Expenditure Panel Survey to compare the insurance payments for and out-of-pocket payments by people with nongroup health insurance and people with ESI.  While premiums for non-group coverage are lower than ESI…

  • Explaining Health Care Reform: Key Changes to the Medicare Part D Drug Benefit Coverage Gap

    Issue Brief

    On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act into law. The health reform law, as modified by the Health Care and Education Reconciliation Act of 2010 which passed the House of Representatives on March 21, 2010 and is under consideration in the Senate, makes several key changes to the Medicare Part D drug benefit to reduce Part D enrollees’ out-of-pocket liability when they reach the coverage gap, known as…

  • Better Care & Lower Costs: Exploring the Promise of Patient Engagement

    Event Date:
    Event

    03/05/10 Engaging consumers more directly in their care may improve health outcomes and help control the costs of care. This briefing, cosponsored by the Alliance for Health Reform and the AARP Public Policy Institute, focused on the potential for changing consumer behavior to promote the use of effective interventions and discourage unnecessary care. It addressed questions such as: How promising are consumer engagement techniques such as patient self-management, shared decision-making and value-based insurance design? What…

  • Americans Remain Split On Stalled Health Care Legislation, but Some Provisions Popular Among Majorities of Democrats, Independents and Republicans

    News Release

    Most See Delays As Driven By Politics Rather Than Policy MENLO PARK, CA – The latest Kaiser Tracking Poll finds the public still split on health care reform legislation, with 43 percent in favor and 43 percent opposed.  However, the poll also finds that majorities of Americans of all political leanings support several provisions in the health reform proposals in Congress and most attribute delays in passing the legislation to political gamesmanship rather than policy…