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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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  • Pulling it Together: A Note on Presidential Leadership Strategy

    Perspective

    In inside circles of the health reform debate there has been criticism of the President for not weighing in earlier and publicly on the details of health reform legislation. Does he want the Senate's approach to employer obligations, or the approach taken in the House? What form of public option does he want: a robust one, a trigger, an opt-in, an opt-out, or none at all? What level of premiums and cost sharing is he…

  • Explaining Health Care Reform: Questions About Medicaid’s Role

    Issue Brief

    Medicaid plays a major role in covering more of the uninsured under the new health reform law. The new law includes a significant expansion of Medicaid, an individual requirement to obtain health insurance, and subsidies to help low-income individuals buy coverage through newly established Health Benefit Exchanges. This brief explains the how Medicaid works today and answers some key questions about Medicaid’s role in health reform. Issue Brief (.pdf)

  • Essential Health Benefits: Balancing Affordability and Adequacy

    Event Date:
    Event

    Under the Patient Protection and Affordable Care Act (PPACA), insurance plans offered through state insurance exchanges as well as non-grandfathered plans offered in the individual and small group markets - will be required to cover a set of health benefits and services called the "essential health benefits" package. Guidance issued last month by the Department of Health and Human Services will give each state some discretion to specify benefits package raises many questions. What is…

  • Coverage of Colonoscopies Under the Affordable Care Act’s Prevention Benefit

    Report

    The Affordable Care Act (ACA) requires private health insurers to cover recommended preventive services such as colonoscopies without any patient cost-sharing. This report finds that confusion over whether colon cancer screenings are preventive care or treatment means patients sometimes receive unexpected bills for the procedure. The report examines cost-sharing practices for colorectal screenings through interviews with experts and officials in the medical and insurance industries. This report was co-authored by The Kaiser Family Foundation, American…

  • Prescription Drug Trends Fact Sheet – May 2010 Update

    Fact Sheet

    This updated fact sheet provides trend information about prescription drug expenditures and coverage, key factors that contribute to rising prescription spending, and efforts to contain rising drug costs. May 2010 Fact Sheet (.pdf)

  • Utilization of Health Care Services by Medicaid Expansion Status

    Issue Brief

    Some critics of Medicaid expansion have argued that expansion diverts resources away from other groups of Medicaid enrollees, including people with disabilities and children, and that expansion enrollees are “able-bodied” implying they have minimal health care needs. However, data show that expansion states spend more per enrollee overall and on each eligibility group than non-expansion states and that nearly half of expansion enrollees have a chronic condition. This data note analyzes 2021 Medicaid claims data…

  • Recibí un Formulario 1095-A del mercado. ¿Qué es?

    FAQs

    El formulario 1095-A le brinda información sobre el monto del crédito fiscal avanzado para primas (APTC) que se pagó durante el año a su plan de salud para reducir su prima mensual. Esta información también fue reportada al IRS. El APTC pagado en su nombre durante el año se basó en el ingreso anual que estimó que ganaría cuando se inscribió en la cobertura del mercado de seguros de salud. Ahora debe presentar una declaración…