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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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  • How Will the Uninsured in Arkansas Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in Arkansas, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Arkansas are eligible for Medicaid or financial assistance in…

  • How Will the Uninsured in Idaho Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in Idaho, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Idaho are eligible for Medicaid or financial assistance in…

  • Poll: Just Over Half of the Nation’s Workforce Have Lost a Job or Income Due to Coronavirus, though Most of Them Believe They Will Get Their Job and Income Back Within Six Months

    News Release

    With many businesses shut down and job losses mounting nationwide, just over half of the nation’s workers (55%) now say they have lost a job or had their incomes reduced as a result of the health and economic crises sparked by the novel coronavirus pandemic, the latest KFF Health Tracking poll finds. This includes a quarter (26%) of all those who were working on Feb. 1 who say they lost a job and another 7%…

  • I am in my early 60s and have signed up for a Marketplace plan so that I have health insurance coverage until I qualify for Medicare at age 65. What happens when I go on Medicare?

    FAQs

    When you turn 65, you should sign up for Medicare and notify your Marketplace plan that you now qualify for Medicare coverage. Your Marketplace coverage will not be cancelled automatically by your plan when you turn 65 and sign up for Medicare, but if you receive premium tax credits to help you pay for your Marketplace plan premium, your eligibility for these tax credits will end when your Medicare Part A coverage starts (people with…

  • I’m enrolled in a student health plan, but now I think I can get a better deal in the Marketplace. Can I drop student health plan coverage and go to the Marketplace instead?

    FAQs

    If you are currently enrolled in a student health plan, you can still apply for Marketplace coverage during the annual Open Enrollment period. If your expected household income is at least $15,650 in 2026, you may qualify for premium tax credits; however, you will have to drop your student health coverage by December 31 to remain eligible for them. Outside of Open Enrollment, you cannot voluntarily drop your student health plan and qualify for Marketplace…

  • Visualizing Health Policy: What Americans Pay for Health Insurance Under the ACA

    Other Post

    The March 2014 Visualizing Health Policy infographic shows examples of what Americans will pay for health insurance under the Affordable Care Act, using different scenarios for 40-year-old individuals living in different parts of the country. Visualizing Health Policy is a monthly infographic series produced in partnership with the Journal of the American Medical Association (JAMA). The full-size infographic is freely available on JAMA’s website and is published in the print edition of the journal. >>View source slides

  • Open Enrollment: Insights from Medicare for Health Insurance Marketplaces

    Perspective

    This Policy Insight draws on the experiences of Medicare beneficiaries during Medicare’s annual enrollment period to consider whether consumers with health insurance coverage through the Affordable Care Act’s new marketplaces will shop for a better deal during their open enrollment season.

  • 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…

  • People in ACA Marketplaces Who Say They Benefited or Were Negatively Affected By ACA

    Feature

    People in ACA Marketplaces Who Say They Benefited or Were Negatively Affected By ACA Download Source Analysis of Kaiser Family Foundation Survey of Non-Group Health Insurance Enrollees, Wave 3 (Feb. 9-Mar. 31, 2016) Related: Column/Op-Ed: Partisanship’s Grip On The Affordable Care Act Survey of Non-Group Health Insurance Enrollees Early Release Methodology