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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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  • Policy Changes Bring Renewed Focus on High-Deductible Health Plans 

    Issue Brief

    Policy changes, anticipated increases in premium costs for enrollees, and new standards for health savings accounts may encourage consumers to seek out plans with lower premiums but higher deductibles. This issue brief explores the features of bronze and catastrophic plans, coverage and costs, and the complicated choices consumers face.

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

    Fact Sheet

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

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

    Fact Sheet

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

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

    Fact Sheet

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

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

    Fact Sheet

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

  • Media Briefing to Release New Survey Tracking California’s Previously Uninsured Residents Under the Affordable Care Act

    Event Date:
    Event

    Media-only web briefing that released a new survey tracking the experiences of California's previously uninsured residents under the Affordable Care Act (ACA). New survey provides a detailed assessment of how well the ACA is working for previously uninsured residents in a state that embraced the ACA's coverage expansion opportunities by establishing the Covered California insurance marketplace and expanding its Medi-Cal program.

  • Obamacare Debate: Where GOP Governors Stand on Repeal and Replace

    From Drew Altman

    As congress prepares to vote on repeal of the Affordable Care Act, Drew Altman discusses whether Republican governors and congressional Republicans will be at odds over key issues when it comes to repealing and replacing the law in this Wall Street Journal Think Tank column.

  • Large Majorities Favor Wide Range of Policy Changes to Curb Prescription Drug Costs, Including Those That Give Government a Greater Role in Negotiating or Limiting Prices

    News Release

    Amid news reports about increases in the price for EpiPen and other drugs, the vast majority of Americans – including majorities of Democrats, Republicans and independents – support several policy changes to control the cost of prescription drugs, including some that would expand government’s role in drug pricing, the latest Kaiser Family Foundation tracking poll finds. About eight in 10 Americans say they favor allowing the federal government to negotiate with drug companies to get…

  • Brief Examines Per Enrollee Medicaid Spending for Seniors and People with Disabilities, Which Varies Greatly By State

    News Release

    Medicaid coverage of acute and long-term care for more than 6 million low-income seniors and 10 million nonelderly people with disabilities accounts for nearly two-thirds of overall Medicaid spending, although such enrollees represent less than a quarter of people on Medicaid.  Much of Medicaid’s spending on seniors and people with disabilities also depends on state decisions about whom to cover and which services to pay for, which is a big reason why Medicaid spending per…