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Affordable Care Act

About the ACA

Promotional image for KFF video How Affordable is the Affordable Care Act

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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  • Do I have to enroll in coverage using HealthCare.gov, or can I apply for Marketplace plans and subsidies on websites run by private companies that sell Marketplace plans?

    FAQs

    HealthCare.gov permits the sale of Marketplace plans through websites run by private companies. These are sometimes described as “direct enrollment” sites or “certified enrollment partner” sites. These websites may be operated by a health insurance company, such as Blue Cross, Ambetter, or Molina. Other websites are operated by web brokers (such as GetInsured.com and Health Sherpa) who are health insurance agents and brokers. Enrolling for coverage through a private website does not disqualify you for…

  • The Implications of the Public’s Pre-existing Condition Amnesia

    Perspective

    KFF’s Larry Levitt discusses waning awareness of the Affordable Care Act’s provisions protecting people with pre-existing conditions and examines the Republican Study Committee's budget proposal, which proposes to repeal the provisions.

  • 2025 Calculadora del Mercado de Seguros Médicos

    Feature

    Esta calculadora ilustra las primas (el costo mensual de su seguro) y subsidios para las personas que compran seguro médico por su propia cuenta en el mercado de seguros de salud (o de intercambio) creado por la Ley de Cuidado de Salud a Bajo Precio (Affordable Care Act, ACA, en inglés). Con esta calculadora, usted puede introducir diferentes niveles de ingresos, edades, y el tamaño de su familia para obtener un estimado de su elegibilidad…

  • Signing Up for Marketplace Coverage Remains a Challenge for Many Consumers

    Policy Watch

    As open enrollment begins for Marketplace plans, this Policy Watch provides information about consumer experiences with Marketplace sign up from the 2023 KFF Consumer Survey. Data from the survey show that Marketplace sign up has been a challenge to many consumers---often more complicated than enrollment in other kinds of health insurance. The Policy Watch also spotlights efforts to address common enrollment problems such as option overload and transitioning to Marketplace coverage from other forms of…

  • Supreme Court Decision Limiting the Authority of Federal Agencies Could Have Far-Reaching Impacts for Health Policy

    Issue Brief

    On June 28, 2024, the U.S. Supreme Court overturned a longstanding legal precedent that required federal courts to defer to reasonable agency interpretation when statutes are ambiguous. The decision will shift many policy decisions from federal agencies to federal judges, with implications for health policy that will reverberate for years to come. This issue brief examines the decision and assesses what’s ahead.

  • Again, No Medicaid

    From Drew Altman

    In his latest column, KFF President and CEO Drew Altman explains why Medicaid, despite former President Donald Trump's silence on the topic, warrants greater attention given the potential for drastic changes or cuts to it should Republicans win control in the election.

  • I learned that my Medicaid coverage has ended. What do I do now?

    FAQs

    If you lose Medicaid but think you still qualify, contact your Medicaid agency. If your coverage ended less than 90 days ago, you may be able to submit any required forms and documents and have your coverage reinstated. If your coverage ended more than 90 days ago, you will likely need to reapply for Medicaid. If the Medicaid agency says you are no longer eligible for Medicaid but you believe that decision was made in…

  • I heard that health plans sold on the Marketplace no longer have to cover certain preventive services. Is that true?

    FAQs

    No, this is not true. Health plans sold on the Marketplace are still required to cover certain preventive services without any patient cost sharing. The categories of preventive services Marketplace plans must cover are: Evidence-based screenings and counseling Routine immunizations Childhood preventive services Preventive services for women Click here for more information on covered preventive services.

  • Private Insurers Expect to Pay $1.1 Billion in Rebates This Year for Setting Premiums Too High Relative to Medical Costs

    News Release

    Private insurance companies are expecting to pay out about $1.1 billion in rebates this fall under an Affordable Care Act (ACA) provision that requires insurers to spend the bulk of customers’ premium payments on care, a new KFF analysis finds. Rebates are based on insurers’ experiences over the previous three years. This year’s estimated total is similar to the $1 billion paid out last year, but well short of the $2.5 billion record total paid…

  • Large Majorities Across Parties Favor Allowing the Federal Government to Negotiate Drug Prices, Even After Hearing Common Arguments About It

    News Release

    Most of the Public Lacks Confidence that President Biden, Congressional Democrats or Republicans Will Do the Right Thing on Drug Prices Allowing the federal government to negotiate with drug companies to lower drug prices for Medicare beneficiaries and people enrolled in private plans – a key cost-saving proposal in the Democrats’ massive reconciliation bill – is favored by large majorities across political partisans, even after they hear arguments from both sides, a new KFF Health…