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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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  • Updated Infographic Explains New Federal Regulations on Contraceptive Coverage

    News Release

    A newly-updated infographic from the Kaiser Family Foundation explains the final regulations on employer-based coverage of birth control released today by the U.S. Department of Health & Human Services. How Does Where You Work Affect Your Contraceptive Coverage? provides a clear explanation of coverage requirements under the new regulations for employers with religious objections to contraceptive coverage, including houses of worship, religiously-affiliated nonprofits and closely-held for-profit corporations. A related summary, also updated to reflect the new regulations,…

  • 5 Key Questions: Medicaid Block Grants & Per Capita Caps

    Issue Brief

    Medicaid covers more than 70 million low-income children, pregnant women, adults, seniors, and people with disabilities in the United States. The program represents $1 out of every $6 spent on health care in the US and is the major source of financing for states to provide coverage for the health and long-term needs of low-income residents. President Trump and other GOP leaders have called for fundamental changes in the structure and financing of Medicaid. This…

  • State Exchange Profiles: North Dakota

    Other Post

    Final update made on December 11, 2012 (no further updates will be made) Establishing the Exchange In November 2012, Governor Jack Dalrymple (R) announced that North Dakota was not planning a state exchange.1 In the previous year, North Dakota had explored the possibility of a state-based exchange, spurred in part by enacted legislation stating North Dakota’s intent to create a health insurance exchange.2 The Insurance Department collected stakeholder feedback and identified a vendor to analyze the state’s…

  • Webinar for Journalists: How the Affordable Care Act Affects Baby Boomers and Medicare Beneficiaries

    Event Date:
    Event

    As part of the "Covering Health Reform" series, this webinar focused on the major changes facing older people. The Foundation's Associate Director of the Program on Medicare Policy, Juliette Cubanski and Senior Fellow Karen Pollitz discussed how the Affordable Care Act impacts Medicare benefits and beneficiaries, as well as the ACA's role for baby boomers who are not yet 65 and eligible for Medicare.

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

    Fact Sheet

    This state report explains how the ACA expands coverage in Michigan, 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 Michigan are eligible for Medicaid or financial assistance in…

  • How Private Health Coverage Works: A Primer – 2008 Update

    Issue Brief

    How Private Health Coverage Works: A Primer— 2008 Update This primer explains the role and operations of private health coverage in the United States. Private health coverage is provided under a variety of different arrangements, including health insuring organizations regulated under state law and health plans sponsored by employers and employee organizations that operate under the federal Employee Retirement Income Security Act (ERISA). The primer discusses the fundamental aims of private health coverage and sorts out…

  • Survey Finds Approximately 3.4 Million Previously Uninsured Adult Californians Obtained Coverage Since Start of the Affordable Care Act’s First Open Enrollment Period

    News Release

    Immigration Status and Fears Pose Challenges to Further Expanding Coverage Among Hispanics Affordability Key Obstacle to Enrollment for Those Who Remain Uninsured MENLO PARK, Calif. -- Nearly six in 10 (58%) previously uninsured Californians report getting health insurance since last summer, finds the second wave of the Kaiser Family Foundation's Longitudinal Panel Survey following the experiences of a randomly selected  panel of uninsured Californians under the Affordable Care Act (ACA). Based on official estimates of…

  • Health-Care Deductibles Climbing Out of Reach 

    News Release

    In his latest column for The Wall Street Journal's Think Tank, Drew Altman explores the trend of higher deductibles in health plans and discusses a new analysis showing that many people with insurance don’t have sufficient financial resources to pay a mid- or high-range deductible. All previous columns by Drew Altman are available online.