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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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  • The Cost of Cancer

    Video

    This Kaiser Family Foundation documentary explores the financial consequences faced by three people, all privately insured, after being diagnosed with cancer. It was released in conjunction with a joint Kaiser/American Cancer Society report, "Spending To Survive: Cancer Patients Confront Holes in the Health Insurance System." The Cost of Cancer: Tom Olszewski Tom Olszewski, a retiree who lives in Texas, had prostate cancer but has been in remission for a decade. His medical history made it…

  • Kaiser Health Tracking Poll — February 2009

    Poll Finding

    The first Kaiser Health Tracking Poll of 2009 finds the public is increasingly worried about the affordability and availability of care, with many postponing or skipping treatments due to cost in the past year and a notable minority forced into serious financial straits due to medical bills. Slightly more than half (53%) of Americans say their household cut back on health care due to cost concerns in the past 12 months. The most common actions…

  • Healthy San Francisco

    Fact Sheet

    In 2007, San Francisco became the first city in the nation to begin implementation of a plan to provide health care services to all uninsured residents. Healthy San Francisco is not health insurance, but rather it provides access to affordable basic and ongoing health care services for uninsured residents. The program provides medical homes to uninsured adults and focuses on prevention and the management of chronic conditions. Fact Sheet (.pdf)

  • Report and Video Highlight Health Coverage Struggles, Other Economic Concerns of Working Families

    Event Date:
    Event

    This report and video from the Kaiser Family Foundation's Commission on Medicaid and the Uninsured (KCMU) illustrate the financial struggles of many families in the United States and show the central role of health care costs and coverage in a household's economic stability. The report, Snapshots from the Kitchen Table: Family Budgets and Health Care, is based on interviews with 27 families from six cities across the U.S.. It finds pervasive uncertainty over job security…

  • Spending To Survive: Cancer Patients Confront Holes in the Health Insurance System

    Event Date:
    Event

    This report highlights the severe challenges cancer patient may face in paying for life-saving care even when they have private health insurance. Jointly authored by the Kaiser Family Foundation and the American Cancer Society, the report profiles 20 patients and illustrates the potential difficulties people diagnosed with cancer or other serious illnesses have in maintaining affordable health insurance and paying for their health care. The patients in the report and accompanying video were selected to…

  • Pulling it Together from Drew Altman: Multiple Agendas for Controlling Health Care Costs

    Perspective

    In what would be a domestic policy trifecta, we may be headed for interconnected big debates about economic recovery, entitlement programs and health reform. A core issue in the entitlement and health reform debates is the problem of rising health care costs. President Obama, now apparently fully briefed on the economic, budget and health reform realities he faces, is talking conspicuously about hard choices that may lie ahead. In a short period of time the…

  • Window of Opportunity?

    From Drew Altman

    Beginning this Spring, between expected approval of an economic stimulus package and the start of campaigning for the midterm election, there will be a rare window of opportunity for passage of major health reform legislation. History suggests that momentum can be lost if policymakers do not move quickly to seize these rare openings when they occur. There is an opportunity now because the nation has a popular new president with political capital to burn who…

  • Pulling It Together: The “R” Word Is Back

    Perspective

    Longer ago than I care to admit, I got my start in health policy at M.I.T. when I wrote a book about health care regulation. The book was about a long forgotten attempt to rationalize the health care system through an elaborate health planning program set up in the seventies under the National Health Planning and Resources Development Act. It established a system of federal, state and regional planning bodies to control health care costs by limiting the supply of…

  • Primers on Key Health Care Topics and Programs

    Issue Brief

    The Kaiser Family Foundation maintains a number of primers providing overviews of key health care programs and issues. Written by Foundation staff, each primer provides key data and information that helps illustrate the topic and its relevance for the nation's health care system. Medicaid: A Primer Medicare: A Primer The Uninsured: A Primer Health Care Costs: A Primer How Private Health Coverage Works: A Primer Mental Health Financing in the United States: A Primer The…

  • Health Coverage in a Period of Rising Unemployment

    Issue Brief

    This policy brief reviews the public and private options available to help people maintain coverage if they become unemployed during a downturn and cannot get employer-sponsored coverage through a spouse. Specifically, it examines COBRA, non-group insurance and Medicaid. And it explains why, despite such options, more people will become uninsured as unemployment rises. Recent analysis predicts that each 1 percentage point increase in unemployment will lead to 1.1 million more uninsured adults. Issue Brief (.pdf)