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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 Politics of Obamacare: How the Affordable Care Act is Playing in the Midterm Elections

    Event Date:
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    In 2010, many political analysts and journalists cited the debate over, and enactment of, the Affordable Care Act (often called "Obamacare") as one factor that helped spark the conservative Tea Party movement and the Republican takeover of the House in that year's Midterm Elections. Four years later, the law's major coverage provisions have taken effect, resulting in new health coverage for millions of Americans, but public opinion on the law remains deeply divided along partisan…

  • The Twin Goals of Health Insurance

    From Drew Altman

    Drew Altman, in The Wall Street Journal's Think Tank, examines a study finding Massachusetts' health reform saved lives in the context of health insurance's twin goal: better access to improve health and economic security.

  • How Much Political Coverage of the Health-Care Law Is Too Much?

    From Drew Altman

    This was published as a Wall Street Journal Think Tank column on June 5, 2014. With primaries underway and the midterms approaching, coverage of the Affordable Care Act will increasingly focus on politics. Many political reporters may take temporary control of the health-care beat during the leadup to November. News organizations should consider: How much Affordable Care Act political coverage is too much? Already, the public says that coverage of the ACA is mostly about politics rather…

  • Health Care Spending is More Than Just the Parts You See

    From Drew Altman

    In this Axios column, Drew Altman looks at total family spending for health including taxes and health benefits, and why people need to understand it to assess proposals like Medicare-for-All.

  • Survey on the Role of Health Care Interest Groups –Toplines

    Poll Finding

    These toplines are of a survey conducted jointly by NPR, the Kaiser Family Foundation, and the Harvard School of Public Health examines the public’s views and opinions of the role of health care interest groups in the ongoing federal health care debate. The survey examines whether people feel their views are represented in the ongoing legislative process and their level of trust in different groups. The survey is part of a series of projects about…

  • Survey of Health Insurance Agents: Assessing Trends in the Individual and Small Group Insurance Markets

    Poll Finding

    This nationally representative survey of 500 health insurance agents and brokers working in the individual and small group markets explores their outlook on market trends and views on the Affordable Care Act (ACA). The survey finds that many agents are seeing steep increases in premiums and deductibles for individuals and small businesses purchasing health insurance. When asked to estimate what they expect to be the typical premium increase in 2012 based on what they have…