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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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  • New Analysis Finds Out-of-Pocket Prescription Drug Spending Decreasing on Average, But More People Spending in Excess of $1,000 a Year

    News Release

    A new Kaiser Family Foundation analysis finds that average annual out-of-pocket prescription drug spending for workers and family members decreased from a recent high of $167 in 2009 to $144 in 2014. Most of the decline in out-of-pocket spending occurred between 2009 and 2012 and is likely due to generic substitution for popular drugs that lost patent protection. The decline in out-of-pocket-spending continued from 2012 to 2014 with nearly two-thirds of the decline during this…

  • Web Briefing for Journalists: Marketplace Open Enrollment in the Trump Era

    Event Date:
    Event

    With the Trump administration’s announcements last week, the landscape around Affordable Care Act marketplaces and the open enrollment period beginning Nov. 1 continues to shift. Though the 2010 health law remains intact for now, consumers will see fundamental differences this year when it comes to signing up for 2018 marketplace plans. Premiums are increasing significantly in some states, though not all consumers will feel the impact. The enrollment period is shorter. Healthcare.gov will experience regular…

  • The Left is Getting More Active on Health Care

    From Drew Altman

    In this Axios column, Drew Altman discusses data from the new KFF/Washington Post survey on activism in America showing the role support for the ACA is playing in motivating political participation, and how, in a reversal from the last election cycle, political energy is shifting from right to left on health care as a new election looms.

  • KFF April Tracking Poll: Opinions of Reform Remain Steady

    Perspective

    This month, public opinion on the health reform law continues to be remarkably steady. The April Kaiser Health Tracking Poll finds that four in ten feel favorably about the law and an equal share say they feel unfavorably. In recent months there has been a slight decline in the share with an unfavorable view of the law, with a corresponding uptick in the share who offer no opinion on the law. The rise in those…

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

    Fact Sheet

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

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

    Fact Sheet

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

  • Kaiser Health Tracking Poll: December 2013

    Feature

    The December Kaiser Health Tracking Poll finds a 13 percentage point rebound in Democratic support for the Affordable Care Act (ACA), but no overall change in support or opposition since November. In spite of all the attention and controversy surrounding the law and its implementation, the poll finds that nearly half of the public say it won't make much difference to them or their families.

  • Web Briefing for Journalists: Consumer Issues Ahead of the Affordable Care Act’s Second Open Enrollment Season

    Event Date:
    Event

    The Affordable Care Act's second annual open enrollment period starts Nov. 15 and runs until Feb. 15 -- a three-month window for Americans to shop for and purchase new health coverage, or change their plan through Healthcare.gov or their state-run insurance marketplace.  This year's open enrollment season poses both new and recurring challenges for consumers:  How are premiums for marketplace plans changing, and what do the changes mean for consumers?  Why might current marketplace customers…