Affordable Care Act

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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  • 2021 Calculadora – Antes COVID-19 Alivio

    Interactive

    Nota: esta calculadora refleja las primas para 2021. Esta calculadora ilustra las primas (el costo mensual de su seguro) y subsidios para las personas que compran seguro médico por su propia cuenta en el nuevo mercado de seguros de salud (o de intercambio) creado por la Ley de Cuidado de Salud a Bajo Precio (Affordable Care Act, ACA, en inglés). Con esta calculadora, usted puede introducir diferentes niveles de ingresos, edades, y el tamaño de…

  • 2021 Calculadora – Antes COVID-19 Alivio

    Interactive

    Nota: esta calculadora refleja las primas para 2021. Esta calculadora ilustra las primas (el costo mensual de su seguro) y subsidios para las personas que compran seguro médico por su propia cuenta en el nuevo mercado de seguros de salud (o de intercambio) creado por la Ley de Cuidado de Salud a Bajo Precio (Affordable Care Act, ACA, en inglés). Con esta calculadora, usted puede introducir diferentes niveles de ingresos, edades, y el tamaño de…

  • Updated KFF Calculator Estimates Marketplace Premiums to Reflect Expanded Tax Credits in COVID-19 Relief Legislation

    News Release

    KFF has updated its 2021 Health Insurance Marketplace Calculator to reflect the expanded premium tax credits available to people who purchase their own coverage through their state’s health insurance exchange as passed by Congress in the American Rescue Plan Act and expected to be signed into law soon. The calculator allows users to enter their age, income, family size, and zip code to assess their eligibility for tax credits and how much they can expect…

  • What about premiums I already paid in 2021?

    FAQs

    The higher premium subsidies are in effect for the 2021 and 2022 plan years.  For premiums you already paid in 2021, before the new law passed, you can claim the increased tax credit when you file your federal income tax return.

  • I am unemployed and receiving UI this year, but my income is low enough to qualify for Medicaid and I live in an expansion state. Can I choose between that and marketplace subsidies?

    FAQs

    No.  If you are eligible for Medicaid you cannot be eligible for marketplace subsidies.  Some people who receive UI benefits will be eligible for Medicaid, in part because Medicaid will NOT take into account the $300 per week federal supplemental UI benefits.  When you apply through the marketplace, you will receive a determination indicating whether you are eligible for Medicaid.  Medicaid coverage is also free or low cost (some states charge a nominal monthly premium…

  • I lost my job and health benefits. I’d like to continue coverage under my group plan through COBRA but am worried I won’t be able to afford it. Is there any help for me?

    FAQs

    Yes.  The American Rescue Plan provides for new, temporary COBRA premium subsidies for people who lost their jobs or had their hours cut so they no longer qualify for group health benefits.  The law provides for a 100% premium subsidy for COBRA for up to 6 months.  The first subsidy-eligible month is April 2021 and the last subsidy-eligible month is September 2021.  Employers will pay the COBRA premium for subsidy-eligible individuals and be reimbursed by…

  • What happens after the COBRA subsidies end in September?

    FAQs

    You can continue on COBRA unsubsidized until your 18 months of COBRA eligibility ends. In addition, you will have the option to enroll in marketplace coverage when the subsidy ends in September.  Loss of the COBRA subsidy will make you eligible for a special enrollment period (SEP) to sign up for marketplace coverage.  If you make your plan selection before the end of September, new marketplace coverage will take effect on October 1.