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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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  • May Kaiser Health Tracking Poll: Four in Ten Say Children and Young Adults Will Be Better Off

    Perspective

    While supporters and opponents of the Affordable Care Act wait for the Supreme Court to announce their decision, support for the law dipped slightly in May, with unfavorable views now outnumbering favorable ones (44 percent versus 37 percent).  As in previous months, the public remains divided on whether the law will leave the country better off (34 percent) or worse off (35 percent). When it comes to their own families, a plurality (37 percent) doesn’t…

  • Public Opinion on Gender Rating

    Perspective

    With the Republican presidential primaries wrapping up, a barrage of new television commercials, radio ads, and fundraising emails has marked the start of the general election campaign. The Affordable Care Act (ACA) continues to be a mainstay election topic for candidates from both major parties. While Republicans focus on advocating repeal of the 2010 health care law, President Barack Obama and the Democratic Party have concentrated on the benefits of the law. And one lesser…

  • KFF Data Note: Americans’ Views on the Personal Impact of the ACA and the Supreme Court’s Decision

    Perspective

    As the Supreme Court hears cases challenging the constitutionality of parts of the Affordable Care Act, a relatively small share of the public thinks the Supreme Court’s decision will have a lot of impact on their family (28 percent). At the same time, the public is divided as to whether the law overall will leave their own families better off (26 percent), worse off (33 percent), or if it won’t make much difference (34 percent).…

  • KFF Data Note: A Snapshot of Public Opinion on the Individual Mandate

    Perspective

    This week, the Supreme Court hears arguments on several challenges to the Patient Protection and Affordable Care Act (ACA), including the provision that requires individuals to purchase health insurance as of 2014, known as the individual mandate. For the two years since the law’s passage, and during the debate leading up to it, this provision has been one of the most controversial aspects of the law. As the lawyers, policymakers, ACA opponents and supporters focus…

  • The Individual Mandate: How Sweeping?

    Perspective

    The so-called "individual mandate"  – the provision under the Affordable Care Act (ACA) that requires most individuals to carry a minimum level of insurance coverage and is now being considered by the Supreme Court – has emerged as the least popular element of the reform law and the prime target for its opponents. Yet in practice, the mandate may not be quite as far-reaching as the controversy over it suggests. The vast majority of Americans already…

  • Kaiser Poll: Early Reaction to Supreme Court Decision on ACA

    Perspective

    Following last week's Supreme Court's decision upholding the heart of the Affordable Care Act (ACA), a majority of Americans (56 percent) now say they would like to see the law's detractors stop their efforts to block its implementation and move on to other national problems. In the first of two polls to be released this month looking at opinion on the ACA in the wake of the Court's decision, Democrats overwhelmingly say opponents should move…

  • KFF Health Security Watch Delaying Health Care to Avoid Cost Common

    Perspective

    While economic challenges facing the country continue and the Supreme Court is deciding the fate of the Affordable Care Act (ACA), May's Health Tracking Poll finds that the problems and concerns related to health care costs and access are wide-spread. A quarter report they have had problems paying medical bills in the past year and six in ten say they have cut corners to avoid health care costs. The survey also finds that health care can…