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Affordable Care Act

About the ACA

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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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  • Facing the Fallout From a King v. Burwell Ruling

    News Release

    With a Supreme Court decision on King v. Burwell looming, Drew Altman's latest column for The Wall Street Journal’s Think Tank plays out the politics of a ruling for the two major parties. All previous columns by Drew Altman are available.

  • A Look at Rural Hospital Closures and Implications for Access to Care: Three Case Studies

    Issue Brief

    The number of rural hospital closures has increased significantly in recent years. This trend is expected to continue, raising questions about the impact the closures will have on rural communities’ access to health care services. To investigate the factors that contribute to rural hospital closures and the impact those closures have on access to health care in rural communities, the Kaiser Commission on Medicaid and the Uninsured and the Urban Institute conducted case studies of…

  • Health Reform: An Overview Tutorial

    Interactive

    This tutorial was produced for kaiserEDU.org, a Kaiser Family Foundation website that ceased production in September 2013. The kaiserEDU.org tutorials are no longer being updated but have been made available on kff.org due to demand by professors who are using the tutorials in class assignments. You may search for other tutorials to view on kff.org. To download this or other tutorials, visit the tutorials archive page.  Slides are available for download using the "Download Slides" link within the…

  • Major Considerations for Repealing and Replacing the ACA

    Event Date:
    Event

    The Kaiser Family Foundation and the Committee for a Responsible Federal Budget host a public forum to discuss the process and implications of repealing and replacing the Affordable Care Act, including the implications of using the budget reconciliation process to repeal the ACA, and what an ACA replacement could mean for health insurance coverage and costs.

  • What’s at Stake with ACA Repeal?

    Interactive

    This interactive includes a map and tables that highlight the increases in health insurance coverage through Medicaid and the Marketplaces as well as the increased federal funding that resulted from the implementation of the ACA.

  • Media Availability on Senate Health Bill

    Event Date:
    Event

    The Kaiser Family Foundation held a media-only conference call Tuesday, June 27, with key experts to explain the Senate Republican health bill and to answer questions about its implications and the CBO’s scoring of the bill. During the call, Kaiser's experts  answered reporters' questions about the bill’s potential impact and implications, including how premiums, tax credits, and insurer participation in the ACA’s marketplaces could change; how the bill would phase out federal funding for the…

  • Public Opinion on ACA Replacement Plans: Interactive

    Interactive

    This interactive includes nationally representative polls of adults in the U.S. that ask about views of plans to replace the Affordable Care Act. See the interactive table for variations in question wording as well as the individual polls included.

  • Brief Examines State Requests to Impose Work Requirements in Medicaid

    News Release

    The proposed American Health Care Act (AHCA) includes a state option to make Medicaid eligibility for nondisabled, nonelderly, non-pregnant adults conditional upon satisfaction of a work requirement. Although the Centers for Medicare and Medicaid Services denied all state Section 1115 waiver requests to institute such work requirements under the Obama administration, earlier this month the Trump administration signaled in a letter to governors that CMS now would be open to considering such proposals. A new…

  • Would States Eliminate Key Benefits if AHCA Waivers are Enacted?

    Issue Brief

    This analysis offers a window into how insurers could respond if the Affordable Care Act's essential health benefits requirement is rolled back, a change being considered by Congressional leaders and allowed through state waivers by the House-passed American Health Care Act as a potential way for lowering premiums.

  • President Obama’s Campaign Position on Health Reform and Other Health Care Issues

    Issue Brief

    During the 2008 Presidential campaign now President Barack Obama announced a comprehensive health care reform proposal and laid out his positions on a number of other key health care issues. The two documents below summarize these campaign policies and positions. They were prepared by the Kaiser Family Foundation with the assistance of Health Policy Alternatives, Inc., and are based on information compiled from Obama's campaign Web site, speeches, campaign debates and news reports. They are…