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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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  • Where can I get help with my Marketplace application?

    FAQs

    All Marketplaces are required to offer "Navigator" programs to help consumers review their plan choices, complete their application, or apply for financial assistance. Navigators can also assist consumers applying for Medicaid or CHIP. Additionally, Navigators can help consumers with post-enrollment support, such as appealing Marketplace decisions. Navigators are paid by the Marketplace, not by health plans, and they must complete Marketplace training and be free from conflicts of interest. You may also be able to…

  • Recibí un formulario 1095-A del mercado de seguros. ¿Qué es?

    FAQs

    El formulario 1095-A brinda información sobre el monto del crédito tributario anticipado para las primas (APTC) que recibió el año anterior. Una copia del formulario también fue reportada al IRS. Guarde una copia en sus récords. El APTC se basó en el ingreso anual que usted estimó que ganaría cuando se inscribió en la cobertura del mercado. Ahora debe presentar una declaración de impuestos federal para calcular su ingreso real para ese año de cobertura.…

  • Estoy cubierta bajo el plan de mis padres y estoy embarazada. ¿El plan de mis padres cubrirá mi atención prenatal y parto?

    FAQs

    Las leyes federales exigen que muchos planes patrocinados por empleadores y todos los planes de seguro individuales que cumplen con la Ley de Cuidado de Salud a Bajo Precio (ACA), incluyendo los disponibles a través de los mercados de seguros, cubran los servicios de maternidad, incluyendo el embarazo, el parto y la atención al recién nacido. Es posible que se apliquen costos compartidos a algunos servicios de maternidad. La mayoría de los planes privados también…

  • I bought emergency contraception over-the-counter (OTC) at my pharmacy and thought it would be covered by my insurance, but I ended up having to pay the full cost out-of-pocket. Why wasn’t it cove...

    FAQs

    Emergency contraception is one of the FDA-approved methods for women that must be covered by most health plans, including those sold on the Marketplace, but it has to be prescribed by a health care provider in order for most insurance plans to cover it. If you don’t have a prescription, you will likely have to pay the full cost out-of-pocket. However, you can ask your provider (or pharmacist if your state allows it) for a prescription…

  • Health Coverage and Care for Youth in the Juvenile Justice System: The Role of Medicaid and CHIP

    Issue Brief

    This brief provides an overview of the health and mental health needs of girls and boys in the juvenile justice system and the role of Medicaid and CHIP in addressing those needs. It focuses on the circumstances of youth who are placed in juvenile justice residential facilities, the discontinuity of Medicaid coverage for those youth, and the options for improving coverage, continuity of care and access to needed services post-discharge, including new opportunities provided by…

  • Updated FAQs Provide New Answers as the Affordable Care Act’s Marketplace Enters Its Second Year

    News Release

    Today, the Kaiser Family Foundation released an updated collection of Frequently Asked Questions (FAQs) providing detailed answers for consumers, and the navigators and brokers who assist them, as the Nov. 15 start date nears for the Affordable Care Act's second open enrollment period. The searchable collection includes nearly 300 up-to-date responses, answering new questions about plan renewal, cancellations, and continuing financial assistance. The FAQs also offer guidance for understanding 2014 federal income taxes in the…

  • Potential Savings from Actively Shopping for Marketplace Coverage in 2016

    Issue Brief

    This analysis looks at how the premiums for the lowest-cost silver plans in Affordable Care Act (ACA) Marketplaces changed between 2015 and 2016. The analysis examines premiums of the 2015 lowest-cost silver plans (in states that used Healthcare.gov in both 2015 and 2016) for a single 40 year-old adult to see how much these premiums increase in 2016 and whether enrollees could obtain lower premiums by switching plans.

  • Visualizing Health Policy: Experiences and Attitudes of Primary Care Practitioners After the ACA

    News Release

    Based on a survey of primary care clinicians in early 2015, this Visualizing Health Policy infographic examines the experiences and attitudes of primary care practitioners (PCPs) after the Affordable Care Act’s (ACA’s) major coverage provisions took effect in January 2014. Although most report no change in their ability to provide quality care, their opinions about the health care law are sharply divided along political party lines. Generally, primary care physicians have a more negative view…

  • States with Section 1115 ACA Expansion Waivers, December 2015

    Feature

    This slide shows the current status of state decisions to use Section 1115 waivers to expand Medicaid. A total of 31 states including DC have adopted the ACA Medicaid expansion, including 6 states with ACA 1115 ACA expansion waivers. AZ has a pending waiver application that seeks changes to its expansion. MT and NH’s waivers will take effect on 1/1/16. PA originally expanded through a waiver but subsequently transitioned to a state plan amendment. TN…

  • Which Path for Health-Care Politics in 2015?

    News Release

    In his first 2015 column for The Wall Street Journal's Think Tank, Drew Altman explains why this year, status quo for the Affordable Care Act is not an option and how the Supreme Court rules in King v. Burwell will determine its path. All previous columns by Drew Altman are available online.