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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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  • Kaiser Health Tracking Poll – August 2017: The Politics of ACA Repeal and Replace Efforts

    Feature

    Following the U.S. Senate’s failed vote on the “skinny repeal”, the latest Kaiser Health Tracking Poll finds that the majority of the public say it is a “good thing” that the Senate did not pass the bill that would have repealed and replaced the ACA. A large share of Americans think President Trump and his administration should do what they can to make the current health care law work and a majority of the public…

  • Kaiser Health Tracking Poll – June 2017: Women’s Health

    Feature

    The Affordable Care Act (ACA) requires employers to cover the full cost of prescription birth control as part of their health insurance plans. The June Kaiser Health Tracking Poll finds that a majority of the public support the requirement for private health insurance plans to cover the full cost of birth control. This includes a majority of Democrats, independents, and Republicans.

  • The Past, Present, And Possible Future Of Public Opinion On The Affordable Care Act

    Feature

    This Health Affairs article reviews 102 nationally representative public opinion polls in the period 2010–19 and finds public opinion has shifted in a sustained way at only two points in time: in a negative direction following technical problems in the first enrollment period, and in a positive direction after President Donald Trump’s election and subsequent Republican repeal efforts.

  • Kaiser Health Policy Tracking Poll: December 2014

    Feature

    With many of the Affordable Care Act’s (ACA) major provisions taking effect this past year, the December Kaiser Health Tracking Poll finds that many Americans are aware of the main parts of the law and, with the exception of the individual mandate, at least 6 in 10 feel favorably towards them. The poll finds the vast majority of the uninsured don’t know the deadline to enroll, most expect to get health insurance in the next…

  • Kaiser Health Policy News Index: November 2014

    Feature

    The Kaiser Health Policy News Index is designed to help journalists and policymakers understand which health policy-related news stories Americans are paying attention to, and what the public understands about health policy issues covered in the news. According to this month’s index, the public remains captivated by news coverage of the Ebola virus. Fewer, but still substantial shares, report following the conflicts in Iraq and Syria and the results of the midterm elections.

  • Kaiser Health Tracking Poll: November 2014

    Feature

    Following the Nov. 4 midterm elections, nearly half of Americans expect increased debate between the two parties over the Affordable Care Act. In comparison, 42 percent say the amount of debate will not change, and very few (5%) say it will decrease. Conducted just prior to the start of the ACA's second open enrollment season, the poll also probes the views of people without health insurance, one of the key target groups for outreach and…

  • Kaiser Calculator Now Gives Consumers 2015 Zip Code-Specific Premium and Tax Credit Estimates for Marketplace Coverage

    News Release

    The Kaiser Family Foundation's Health Insurance Marketplace Calculator now includes zip code-specific data on 2015 health plans that are being sold through the Affordable Care Act’s insurance marketplaces during the open enrollment period beginning Saturday, Nov. 15. With the new tool, consumers around the nation can generate estimates of their health insurance premiums and government subsidies for 2015 plans that they purchase on their own through an ACA marketplace. The estimates are based on zip…

  • Kaiser Health Policy News Index: April 2015

    Feature

    The health policy stories included in this month’s Kaiser Health Policy News Index were followed closely by about 4 in 10 Americans. Of the stories asked about this month, the one that garnered the most attention was coverage of the white police officer charged with the murder of an unarmed black man in South Carolina. Over half report closely following other stories, including the Germanwings plane crash in the French Alps, a new religious freedom…

  • Kaiser Health Tracking Poll: April 2015

    Feature

    This month’s Kaiser Health Tracking Poll finds public opinion of the Affordable Care Act (ACA) continues to be almost evenly split The poll also asks about health care priorities for the President and Congress, and the concern that comes out on top for Democrats, Republicans and independents alike is making sure that high-cost drugs for chronic conditions are affordable to those who need them. Other than high-cost prescription drugs, Democrats, Republicans and independents have different…