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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: Perspectives on State Health Reform

    Perspective

    This Pulling It Together column is the fourth in my new series. All four so far have dealt with different dimensions of health reform. This time I write about one of my favorite topics, the states. As a former head of an umbrella health and social services agency in a big state responsible for about a third of a state budget and workforce, I have a deep appreciation for state government. It's a level of…

  • Uninsured Young Adults: A Profile and Overview of Coverage Options

    Issue Brief

    Young adults, age 19-29, have the highest uninsured rate of any age group. Since 29% of the uninsured are young adults, efforts to decrease the overall number of uninsured must address this population. This brief examines health coverage for young adults, as well as their health status, access to care, and the financial burdens they encounter when paying for care. It also provides an overview of public and private approaches to expand health coverage for…

  • Addressing Disparities in Health and Health Care — Issues for Reform

    Event

    Marsha Lillie-Blanton, Dr.P.H., Kaiser senior advisor on race, ethnicity and health care, testified before the House Ways and Means Health Subcommittee about the role of health insurance in reducing disparities in health care and in health status. The testimony is part of an ongoing health reform hearing series. Testimony (.pdf) Slides (.ppt)

  • Testimony: State-Based Health Reform Efforts

    Event

    On June 16, 2008, Kaiser Family Foundation Vice President Gary Claxton testified about state-based health reform efforts as part of the Senate Finance Committee's Preparing For Launch Health Reform Summit. In his prepared testimony, he examined the role of Medicaid and the State Children's Health Insurance Program, as well as the way various federal laws and policies may limit innovation at the state level. Testimony (.pdf)

  • Pulling It Together: Health IN the Economy

    Perspective

    I am writing this Pulling It Together column about this one chart and its potential interpretations and implications. Source: Key Findings: Kaiser Health Tracking Poll: Election 2008 -- April 2008, Kaiser Family Foundation, April 2008. This chart from our most recent tracking poll shows the economy rising as a political issue and health care falling, with Iraq in the middle. Findings from other polling groups will show the same thing for as long as the economy…

  • Survey Brief: Economic Problems Facing Families

    Poll Finding

    This poll finds that health care costs rank among Americans’ top personal economic problems, and their struggles to deal with those costs have affected both their financial well-being and their family’s health care. Conducted by the Foundation’s public opinion researchers, the poll probes into the economic concerns facing Americans and the ways they have dealt with the cost of health care. The poll was designed and analyzed by public opinion researchers at the Kaiser Family…

  • Kaiser Health Tracking Poll: Election 2008 — April 2008

    Poll Finding

    An April 2008 poll finds that health care costs rank among Americans’ top personal economic problems, and their struggles to deal with those costs have affected both their financial well-being and their family’s health care.  Conducted by the Foundation’s public opinion researchers, the poll probes into the economic concerns facing Americans and the ways they have dealt with the cost of health care. Across a series of economic concerns, health care costs rank near the…

  • New Analysis Shows Effect of Rising Unemployment on Health Coverage, Medicaid and SCHIP Spending and Enrollment

    Event

    As the country faces another economic downturn, many states are scrambling to deal with the impact of poor economic conditions on programs, like Medicaid and the State Children’s Health Insurance Program (SCHIP), that are reliant on state funding. To be better able to cope, states are looking for fiscal relief from the federal government as well as obtaining a moratorium on federal regulations that would reduce Medicaid funding for states from the Congress. New analyses…

  • How Private Health Coverage Works: A Primer – 2008 Update

    Issue Brief

    How Private Health Coverage Works: A Primer— 2008 Update This primer explains the role and operations of private health coverage in the United States. Private health coverage is provided under a variety of different arrangements, including health insuring organizations regulated under state law and health plans sponsored by employers and employee organizations that operate under the federal Employee Retirement Income Security Act (ERISA). The primer discusses the fundamental aims of private health coverage and sorts out…

  • Health Care Affordability and the Uninsured

    Event

    Diane Rowland testified at a hearing on the instability of health coverage before the Health Subcommittee of the U.S. House Committee on Ways and Means. Her testimony discussed the growing share of Americans who are uninsured and without adequate health insurance coverage and highlighted the key characteristics and issues with regard to the uninsured as well as the financial burdens for medical care faced by America's families. Testimony (.pdf)