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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 Public’s Health Care Agenda for the 112th Congress

    Poll Finding

    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 to a survey conducted by researchers from the Kaiser Family Foundation and the Harvard School of Public Health. The survey also showed that there is no groundswell of public support for overturning the law, that many individual components of the legislation remain popular across the political spectrum and…

  • State Variation and Health Reform: A Chartbook

    Report

    This chartbook pulls together data related to state variation in key areas such as major industry types, poverty and unemployment rates and fiscal conditions; health coverage and the uninsured; Medicaid and CHIP eligibility and enrollment; Medicaid spending and financing; access to Health Care; health care costs; and insurance markets.

  • Statement of Gary Claxton to NAIC Exchanges (B) Subgroup

    Event Date:
    Event

    Kaiser Family Foundation Vice President Gary Claxton, who directs the Foundation's Marketplace Policy Project, testified July 22, 2010, at a public hearing before the National Association of Insurance Commissioners' Exchanges (B) Subgroup established by the health reform law.  Testimony (.pdf)

  • Immigration Reform and Access to Health Coverage: Key Issues to Consider

    Issue Brief

    The Obama administration and a bipartisan group of U.S. senators recently released blueprints for immigration reform proposals that include a roadmap to citizenship for the 11 million undocumented immigrants currently residing in the United States. Subject to meeting specified requirements, these individuals would be able to apply for a provisional lawful status. After completing an undefined number of years in this status, an individual would then be allowed to apply for lawful permanent residency and,…

  • Pulling It Together: Critical Path To Health Reform

    Perspective

    In this new section of our Web site, I pull together ideas and data from across the Foundation’s work to try to paint a bigger picture that hopefully helps to illuminate critical health policy issues. This is not a blog or a personal position statement. This second installment of the new Pulling It Together series lays out the steps that could lead to the first major national health reform debate since the early nineties. Other…

  • Kaiser Health Tracking Poll — March 2012

    Feature

    As the oral arguments on the Affordable Care Act (ACA) begin in two weeks before the Supreme Court, the March Kaiser Health Tracking Poll finds that Americans' views on the case mirror their views on the health reform law and that they expect parts of the ACA to continue whatever the Court rules. The poll finds that half of all Americans (51%) think the Court should rule the mandate unconstitutional and about the same number…

  • Pop Quiz: Assessing Americans’ Familiarity With the Health Care Law

    Feature

    The Affordable Care Act (ACA) is coming up on a year old, but in the midst of continuing debate over the merits of the landmark health care overhaul, how well do Americans understand what the new law will actually do? As the 112th Congress prepared to take office and the discussion of repeal was on the rise, the Foundation included a ten-question "quiz" on the December Kaiser Health Tracking poll to try to answer this…

  • Kaiser Health Tracking Poll — October 2010

    Feature

    With the November midterm elections just weeks away, Americans remain chronically divided over the Patient Protection and Affordable Care Act, but most say that their feelings – pro and con – about the health reform law are not a dominant factor in how they will vote for Congress or whether they will go to the polls. Views on health reform tightened up in October, with 42 percent saying they have favorable views of the new…

  • Pulling it Together: REPOR(t)

    Perspective

    In today’s column I investigate a somewhat lighter topic than my last column on micro-simulation modeling: What was the impact of shows like Jon Stewart’s The Daily Show and Stephen Colbert’s The Colbert Report on the health reform debate?  Who among us has not wondered about the answer to this question?  Please don’t answer that. I should start by acknowledging that I am a frequent but not religious viewer of these shows, and believe that…

  • Medicaid Coverage and Spending in Health Reform: National and State-By-State Results for Adults at or Below 133% FPL

    Report

    This analysis, performed by the Urban Institute for the Kaiser Commission on Medicaid and the Uninsured, shows that the expansion of Medicaid under the health reform law will significantly increase the number of people covered by the program and reduce the uninsured in states across the country, with the federal government picking up the vast majority of the cost. The analysis is among the first to show for all 50 states and the District of…