Affordable Care Act

About the ACA

Promotional image for KFF video How Affordable is the Affordable Care Act

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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  • Community Care of North Carolina: Putting Health Reform Ideas into Practice in Medicaid

    Issue Brief

    This policy brief examines the structure and experience of Community Care of North Carolina, an enhanced medical home model of care that North Carolina began implementing in 1998 as part of its Medicaid program. Evaluations of the initiative, which includes a heavy emphasis on care coordination, disease and care management and quality improvement, suggest that it has resulted in both improved care and cost savings. The program provides important lessons for broader health reform efforts…

  • Health Care Reform Newsmaker Series: Sen. Chris Dodd

    Event Date:
    Event

    This webcast captures an April 28, 2009 briefing with Sen. Chris Dodd (D-Conn.), senior member of the U.S. Senate Committee on Health, Education, Labor and Pensions. The briefing was part of the Health Care Reform Newsmaker series sponsored by the Kaiser Family Foundation, Families USA and the National Federation of Independent Business. The reporters-only briefings, designed to inform the public about prospects and options for health reform, feature a short presentation by an influential leader…

  • Pulling it Together: 19.7

    Perspective

    Several years ago Joanne Silberner from NPR offered some advice I liked. Joanne said that the secret to effective communication was to "have a killer anecdote and a killer number." Here is a killer number: 19.7. That's the average number of years between major attempts at health reform since Harry Truman made health reform a top priority and his plan was branded a socialist plot and soundly defeated in 1950. The chart below chronicles the…

  • Health Care Reform Newsmaker Series: Nancy-Ann DeParle, Director of the White House Office of Health Reform

    Event Date:
    Event

    Nancy-Ann DeParle, director of the White House Office of Health Reform, appeared as the third guest in a series of Health Care Reform newsmaker briefings sponsored by the Kaiser Family Foundation, Families USA and the National Federation of Independent Business. The reporters-only briefings, designed to inform the public about prospects and options for health reform, feature a short presentation by an influential leader followed by an extended question-and-answer session.  Transcript (.pdf) Video

  • The Public and the Health Care Delivery System

    Poll Finding

    This survey by NPR and researchers at the Kaiser Family Foundation and the Harvard School of Public Health highlights the public’s attitudes and experiences with the American health care delivery system. The new survey sheds light on Americans’ experiences with issues more typically discussed by health policy experts – including electronic medical records, coordination of care and comparative effectiveness – all of which have become serious components of reform plans and some of which have…

  • April 2009 Health Tracking Poll

    Poll Finding

    The April Kaiser Health Tracking Poll finds that six in ten Americans continues to say that they or a member of their household have delayed or skipped health care in the past year. A solid majority of the public believes health care reform is more important than ever because of current economic problems. The country’s overall economic problems have not dampened their interest in pursuing health care reform: a solid majority of the public (59%)…

  • The Public and the Health Care Delivery System — Summary and Chartpack

    Poll Finding

    This summary and chartpack of the results of a survey by NPR and researchers at the Kaiser Family Foundation and the Harvard School of Public Health highlight the public's attitudes and experiences with the American health care delivery system. The new survey sheds light on Americans' experiences with issues more typically discussed by health policy experts –- including electronic medical records, coordination of care and comparative effectiveness –- all of which have become serious components…

  • The Public and the Health Care Delivery System — Toplines

    Poll Finding

    These toplines from a survey by NPR and researchers at the Kaiser Family Foundation and the Harvard School of Public Health highlight the public's attitudes and experiences with the American health care delivery system. The new survey sheds light on Americans' experiences with issues more typically discussed by health policy experts –- including electronic medical records, coordination of care and comparative effectiveness –- all of which have become serious components of reform plans and some…

  • Health Care Reform Newsmaker Series: Sen. Chuck Grassley (R-Iowa)

    Event Date:
    Event

    Sen. Chuck Grassley (R-Iowa), ranking Republican member of the Senate Committee on Finance, appeared as a guest in the new series of Health Care Reform newsmaker briefings sponsored by the Kaiser Family Foundation, Families USA and the National Federation of Independent Business. The reporters-only briefings, designed to inform the public about prospects and options for health reform, feature a short presentation by an influential leader followed by an extended question-and-answer session.  Transcript (.pdf) Video