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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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  • How Many of the Uninsured Can Purchase a Marketplace Plan for Free in 2020?

    Issue Brief

    This analysis looks at how many of the remaining uninsured are eligible for premium subsidies that are large enough to cover the entire cost of a bronze plan, which is the minimum level of coverage available on the Marketplaces. It estimates 28% of uninsured individuals who could shop on the ACA Marketplace, or 4.7 million people nationwide, are eligible to purchase a bronze plan with $0 premiums after subsidies in 2020.

  • The Affordable Care Act’s Enduring Resilience

    Perspective

    In this article in the Journal of Health Politics, Policy and Law, Larry Levitt examines the Affordable Care Act 10 years after it's enactment. The article notes that the law has taken numerous blows, yet due to its policy design and the political forces it has unleashed, the law has shown remarkable resilience.

  • KFF March Health Tracking Poll: One Year Later, Views on Health Reform Remain Divided

    Perspective

    Health reform is a year old and the latest Kaiser Health Tracking Poll finds a basic division that has changed little during the last 12 months. This month, 42 percent of Americans hold favorable views of the law while 46 percent view it unfavorably. In April 2010, the month after passage, 46 percent had favorable views and 40 percent unfavorable ones, but both figures have ticked up and down over the last year. Opinion of…

  • The Trump Administration’s Hidden Attacks on the Affordable Care Act

    Perspective

    In a Washington Post op-ed, “The Trump administration’s hidden attacks on the Affordable Care Act,” Larry Levitt discusses the latest proposed regulations by the Trump administration to expand association health plans: changes that could wound the ACA insurance marketplace, but are unlikely to make it collapse.

  • 2008 Presidential Candidates: Health Care Issues Side-by-Side

    Other Post

    Health care has been an important issue in the 2008 presidential campaign and the candidates have staked out positions on key health care issues. Both major party candidates have developed comprehensive health care reform proposals addressing health coverage and access, rising health care costs and health care quality. The side-by-side comparison available here focuses on important health care issues not necessarily addressed in the candidates' health care reform proposals. It was prepared by the Kaiser…

  • Online Applications For Medicaid And/Or CHIP: An Overview of Current Capabilities And Opportunities For Improvement

    Issue Brief

    This analysis provides an overview of online applications for Medicaid and/or CHIP and examines the extent to which they incorporate features that streamline and simplify the enrollment process for individuals. Thirty-two states currently offer an online application for one or both of these programs that is accessible by the public and can be electronically submitted, although they vary in their features. A key component of the Patient Protection and Affordable Care Act is the creation…

  • Optimizing Medicaid Enrollment: Spotlight on Technology – Wisconsin’s ACCESS Internet Portal

    Issue Brief

    This brief examines how ACCESS, a web-based, self-service tool developed by the state of Wisconsin, helps Wisconsin residents find out whether they may be eligible for BadgerCare Plus and other public programs, as well as apply for benefits, check and renew benefits, and report changes to keep their eligibility current -- all online. It is the second brief in a Spotlight on Technology series profiling several states' innovative applications of technology to Medicaid enrollment efforts.…

  • Proposed Models to Integrate Medicare and Medicaid Benefits for Dual Eligibles: A Look at the 15 State Design Contracts Funded By CMS

    Issue Brief

    This brief summarizes 15 states' preliminary proposals to better coordinate care for people who are in both the Medicare and Medicaid programs. The design contracts, funded by the federal Center for Medicare and Medicaid Innovation (CMMI), are an outgrowth of new efforts under the health reform law to develop service delivery and payment models that integrate care for the nation’s nearly 9 million "dual eligibles," whose medical needs and health care costs typically exceed those…