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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 ACA and People with HIV: An Update

    Issue Brief

    This report provides a second look at how the Affordable Care Act (ACA) is impacting people with HIV two years into these new coverage opportunities, based on focus groups conducted with HIV positive individuals from five states in early 2016, after the third round of open enrollment. Groups were conducted with HIV positive individuals who gained insurance coverage – through either the Marketplaces or Medicaid expansion- in California and New York and with those who…

  • Survey: Assisters Help Estimated 5.3 Million During 2016 ACA Open Enrollment, Down 10 Percent from Prior Year

    News Release

    During the third Affordable Care Act open enrollment period, assistance programs helped an estimated 5.3 million people -- a number that was 10 percent lower than the prior year and that included a higher share of people renewing coverage, finds a new Kaiser Family Foundation survey of assister programs and brokers. Both assisters and brokers report a shift toward more return customers among those who sought assistance during the 2016 ACA open enrollment period, which…

  • What would ACA Subsidies Have Been in 2022 if COVID-19 Relief Had not passed?

    Interactive

    This calculator is for illustration purposes and shows the tax credits and premiums that marketplace customers would have paid in 2022 if not for the enhanced subsidies included in the 2021 COVID relief legislation, the American Rescue Plan Act, (ARPA). The enhanced subsidies expire at the end of the year.

  • Medicare Spending Cuts and Hospital Productivity Gains

    From Drew Altman

    In this column for The Wall Street Journal's Think Tank, Drew Altman and guest co-author Dana Goldman examine hospital productivity gains, and what they may mean for hospitals’ ability to absorb spending reductions.

  • ANALYSIS: ACA Marketplace Premiums Rise Substantially in 2018, But Many Will Pay Less for Coverage

    News Release

    Premiums will rise substantially in 2018 Affordable Care Act marketplace plans for states using HealthCare.gov, but in many cases, people receiving premium tax credits will pay less than they did in 2017, a new Kaiser Family Foundation analysis finds. The new analysis includes county-level interactive maps charting premium changes of lowest-cost gold, silver, and bronze plans for consumers with and without premium tax credits in the 2018 HealthCare.gov marketplaces. For people not eligible for tax…

  • Kaiser Family Foundation/NBC News Survey Questions

    Poll Finding

    The Kaiser Family Foundation partnered with NBC News to ask several survey questions of the U.S. public about their feelings towards the 2010 health care law, as well as their worries about affording health care more generally. These questions were asked as part of the September 2013 Kaiser Health Tracking Poll. Kaiser Family Foundation/NBC News Survey Topline Download

  • Drew Altman: Amid Tensions, Legal Immigrants Fear Signing Up for Obamacare

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman discusses new Kaiser Family Foundation survey findings about how fear of enforcement of immigration laws may be affecting Latino enrollment in the Affordable Care Act. All previous columns by Drew Altman are available online.