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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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  • Kaiser Health Tracking Poll — April 2010

    Feature

    The first Kaiser Health Tracking Poll fielded since the passage of health reform last month finds that 8 in 10 Americans know that President Obama signed the legislation into law. But 55 percent say they are confused about the law and more than half (56%) say they don’t yet have enough information to understand how it will affect them personally. The poll finds that the public supports many of the provisions of health reform that…

  • Kaiser Health Tracking Poll — March 2010

    Feature

    The March Kaiser Health Tracking Poll finds the public still divided on health reform legislation, with 46 percent of Americans backing the reform proposals on Capitol Hill, 42 percent opposing them and 12 percent saying they aren't sure. Six in 10 Americans say they have heard little or nothing about budget reconciliation. And many people continue to struggle with health costs, with nearly one in five saying cost increases have caused them or their employer…

  • Health Care and the Economy in Two Swing States: A Look at Ohio and Florida

    Poll Finding

    Two new surveys by NPR, the Kaiser Family Foundation and the Harvard School of Public Health examine the pocketbook problems facing people in Ohio and Florida -- two presidential swing states -- including their struggles with gas prices, getting and keeing a well-paying job and affording health care. The surveys, , also take an in-depth look at the impact of medical bills on family finances and health care, and provide insights into the way health…

  • 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…

  • Kaiser Health Tracking Poll: November 2012

    Feature

    The November poll finds that while health care ranked as a second-tier issue in this month's election, President Obama and Republican nominee Mitt Romney tied among voters who felt strongly about the Affordable Care Act, and President Obama won an advantage among voters who said Medicare was important to their vote, and among women on women’s health issues. The November poll is the latest in a series designed and analyzed by the Foundation's public opinion…

  • Kaiser Health Tracking Poll — May 2012

    Feature

    The May Health Tracking Poll focuses on the public's perceptions and reactions to women's reproductive health reemerging as a heated issue in policy debates and news and its potential impact on the upcoming presidential election. Three in ten women (31 percent) overall believe that there is currently a "wide-scale effort to limit women's reproductive health choices and services, such as abortion, family planning, and contraception" in the U.S. A larger share (45 percent) say there…

  • Medicaid Spending Growth over the Last Decade and the Great Recession, 2000-2009

    Report

    This report examines Medicaid spending growth nationally during the last decade, with a focus on growth during the recession of 2007 to 2009. The recession-driven enrollment growth in recent years drove program spending to increase faster than national health spending overall, but on a per enrollee basis the growth in Medicaid spending has remained lower than the rise in private insurance premiums and overall national health expenditures. The recession-driven increase in Medicaid enrollment has been…

  • Pulling it Together: Forget Math and Science, Teach Civics (Or Why We Need to Bring Back Schoolhouse Rock)

    Perspective

    I am seldom surprised by our poll findings, but this month’s tracking poll produced a doozy.  Twenty-two percent of the American people think the Affordable Care Act has been repealed, and another 26 percent aren't sure.  Those are surprisingly large numbers even with the 52 percent who still know it is the law of the land. How could a repeal "vote" in the House -- however dramatic but still, only symbolic -- be misunderstood as…

  • Kaiser Health Tracking Poll — December 2010

    Feature

    As 2010 draws to a close, the latest tracking poll shows the public still divided in their views of the health reform law, a sentiment largely unchanged since the law’s enactment in March. Forty-two percent of Americans say they have a generally favorable view of the law, while 41 percent have a generally unfavorable view of it. Seniors, generally more critical of the law than younger people, seem to be softening in their opposition as…

  • Alternatives for Financing Medicaid Expansions in Health Reform

    Report

    Expanding Medicaid to cover low-income populations has been a fundamental component of leading health reform proposals. The House Leadership Bill would expand Medicaid to 150 percent of the federal poverty level and the Senate Leadership Bill would expand Medicaid to 133 percent of the federal poverty level. In both scenarios the federal government would finance a substantial share of costs for the expansion groups.  This analysis, however, shows that it is possible to distribute increased…