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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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  • After King v. Burwell Ruling, Health Law Issues Involve Implementation

    News Release

    After today’s Supreme Court ruling upholding the Affordable Care Act’s federal subsidies, Drew Altman's latest column in The Wall Street Journal's Think Tank explores what the decision means and what’s next for the health law. All previous columns by Drew Altman are available.

  • Health Care Costs Top the Public’s List of Financial Worries, and Those Who Are Struggling the Most Want to Hear Presidential Candidates Discuss Economic and Health Care Issues

    News Release

    At a time when kitchen table economic problems are on voters’ minds, unexpected medical bills and health care costs top the public’s list of financial concerns, and voters who are struggling to pay their monthly bills are the most eager to hear the presidential candidates talk about economic and health care issues, the latest KFF Health Tracking Poll finds. Nearly 3 in 4 adults say they are worried about being able to afford unexpected medical…

  • Report Finds State Costs of Implementing The Affordable Care Act’s Medicaid Expansion Would Be Modest Compared to Increases in Federal Funds, and Some States Would See Net Savings

    News Release

    Washington, D.C. – A new report released today by the Kaiser Family Foundation shows modest state costs for implementing the Medicaid expansion under the Affordable Care Act compared to significant increases in federal funds, allowing some states to see net budget savings even as millions of low-income uninsured Americans gain health coverage. The new, updated analysis, conducted by John Holahan, Matt Buettgens, Caitlin Carroll and Stan Dorn at the Urban Institute for the Foundation's Commission…

  • 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)

  • Toplines: Kaiser Health Tracking Poll: Election 2008 — October 2008

    Poll Finding

    This document contains the detailed toplines from the October Kaiser Health Tracking Poll: Election 2008 poll. The poll involved a nationally representative random sample of 1,217 adults ages 18 and older, including 1,115 adults who say they are registered to vote, who were interviewed by telephone between October 8 and 13, 2008. The margin of sampling error for the full sample is plus or minus 3 percentage points and plus or minus 4 percentage points…

  • Pulling It Together: What Conservatives Won In Health Reform (And Don’t Seem to Know It)

    Perspective

    Conservatives obviously don't like what they call "Obamacare" because they think it expands the role of government too much and spends too much money.  But ironically, the Affordable Care Act (ACA) actually promotes -- though not explicitly -- something that has been a fundamental objective of conservatives in health care for years: high-deductible health plans with more "skin in the game." In a new study we just released, we commissioned three different actuarial consulting firms…