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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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  • Chronic Disease and Co-Morbidity Among Dual Eligibles: Implications for Patterns of Medicaid and Medicare Service Use and Spending

    Report

    The health reform law contains provisions that aim to improve the delivery and coordination of services for persons enrolled in both Medicaid and Medicare, known as the dual eligibles. This population includes individuals with some of the most severely disabling chronic conditions. While the higher costs associated with services to dual eligibles is well-known, information on how spending is distributed across these programs is less understood. This study uses linked Medicare and Medicaid data to…

  • 2008 Update on Consumers’ Views of Patient Safety and Quality Information

    Poll Finding

    2008 Update on Consumers' Views of Patient Safety and Quality Information An updated examination of consumers' views on health care quality information reveals major challenges remain in providing the public with comparative quality information and encouraging its use. The 2008 Update on Consumers' Views of Patient Safety and Quality Information finds that three in 10 (30%) Americans say they have seen health care quality comparisons of health insurance plans, hospitals, or doctors in the past…

  • Data Note: Footing the Bill

    Poll Finding

    This brief data note looks at the raft of polls recently released on the public’s willingness to pay for an expansion of coverage to their fellow citizens. It compares and contrasts findings on Americans’ general inclinations on the topic, and also revisits recent findings on specific revenue raising proposals. Data Note (.pdf)

  • Quality Ratings of Medicare Advantage Plans: Key Changes in the Health Reform Law and 2010 Enrollment Data

    Issue Brief

    NEW: Foundation brief looks at implications of 2011 quality ratings for Medicare Advantage plans. This Kaiser Family Foundation issue brief examines the key changes in this year’s health reform law that will reward bonuses to private Medicare Advantage plans based on quality rating. Medicare currently rates plans on a five-star scale, with five stars representing the highest quality. The brief analyzes plans based on their quality rating for the current year and also examines enrollment…

  • I’m covered under my parents’ plan and I’m pregnant. Will my parents’ plan cover my prenatal care and delivery?

    FAQs

    Federal laws require many employer-sponsored plans and all ACA-compliant individual insurance plans, including those available through the Marketplaces, to cover maternity services, including pregnancy, childbirth, and newborn care. Cost sharing may apply to some maternity services. Most private plans also must cover prenatal visits and screenings, folic acid supplements, tobacco cessation counseling and interventions, and breastfeeding services without any cost-sharing because they are considered preventive services. Some health plans are not required to cover all…

  • Tuve cobertura con un plan del mercado de seguros este año y estoy seguro que nunca olvidé un pago. Pero la aseguradora dice que no pagué la prima de octubre y no me dejarán renovar la cobertura para el...

    FAQs

    Esto no está claro. Por ahora, el gobierno federal no ha establecido un proceso claro para apelar por problemas que surjan bajo la nueva regla. Es importante que usted se registre para tener cobertura antes del final del Período de Inscripción Abierta. A este punto, las opciones para considerar incluyen: Pídale a su aseguradora que reconsidere. Asegúrese de presentar una copia de cheque u otra prueba de que la prima se pagó Reporte este problema…

  • Health Policy in 2020 Will Be Made in the States

    From Drew Altman

    With a questionable outlook for 2020 passage of legislation on prescription drug pricing and surprise medical bills, Drew Altman says the real action to watch in health policy is likely to be in the states.

  • ACA Open Enrollment: If You Shop on Private Websites Instead of HealthCare.gov

    Fact Sheet

    Marketplace plans can now be sold through private websites, sometimes described as "direct enrollment” sites or “certified enrollment partner” sites. This short fact sheet explains how these sites and the plans they offer may differ from what consumers will find on HealthCare.gov.

  • What Does the Election Mean for Health Reform and Other Health Issues?

    Event Date:
    Event

    How the new health reform law is implemented, and how quickly, depend in part on the results of the November 2 election. Now that the leadership of the House will soon change hands, what might Republicans do with respect to health reform? How might Democrats respond? Apart from reform, how might other health programs such as Medicare, Medicaid and CHIP be affected by the new congressional lineup? This November 12 briefing, cosponsored by the Alliance…