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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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  • Could Trump Walk Away from Unpopular Health Proposals?

    From Drew Altman

    In a new column, KFF President and CEO Drew Altman discusses what President Trump’s decision to pull back the broad freeze in federal grant funding might portend for his response to future policies in health that prove controversial or unpopular.

  • Health Policy is Partisan, But It’s Also Personal

    From Drew Altman

    In his latest column, KFF President and CEO Drew Altman explores how America's big health care programs — Medicaid, Medicare, and the Affordable Care Act (ACA) — provide popular benefits valued by Americans from across the political spectrum. As partisan debates move closer to legislation, people may focus more on their personal financial concerns.

  • More On Health and Politics: The Peculiar Timing of Republican Health Policy Plans

    From Drew Altman

    In this column, KFF President and CEO Drew Altman examines the conservative Republican Study Committee’s sweeping proposals to remake Medicare, Medicaid and the Affordable Care Act and their potential to make waves in this year’s elections. Whether former President Trump ignores, embraces, or repudiates their ideas will be key.

  • The CBO Report That Didn’t Roar

    From Drew Altman

    In his latest column, KFF President and CEO Drew Altman discusses a recent Congressional Budget Office (CBO) estimate that the Centers for Medicare and Medicaid Innovation (CMMI)'s payment and delivery demonstrations have cost Medicare money, and what it means for the future of value-based payment.

  • It’s Not a Health Care Election, But Health Issues Might Still Add Up

    From Drew Altman

    In this column, KFF President and CEO Drew Altman explores the potential for some health care issues—including abortion, drug costs and other affordability challenges—to influence enough voters in swing states to make a difference in this year's presidential election.

  • Web Briefing: The California v. Texas Supreme Court Case and Its Implications for the ACA

    Event Date:
    Event

    On Tuesday, Nov. 10, the Supreme Court will hear oral arguments on a legal challenge supported by the Trump administration that seeks to overturn the Affordable Care Act, an outcome that would have major effects throughout the health care system as the law’s provisions have affected nearly all Americans in some way. KFF held an interactive web briefing on Monday, Nov. 9, to share insights about the legal issues in the case and the potential…

  • Soy un adulto joven y necesito seguro de salud. ¿Cuáles son mis opciones de cobertura?

    FAQs

    Hay varias opciones que pueden estar disponibles: Si sus ingresos son de $21.597 o menos en 2026 (138% del nivel federal de pobreza para un adulto solo), puede calificar para cobertura de Medicaid. No todos los estados han optado por ampliar la elegibilidad para Medicaid para este nivel de ingresos. Consulte con un navegador u otro asistente usando la herramienta “Buscar Ayuda Local” en su mercado de seguros para obtener más información sobre la elegibilidad…

  • ¿Pueden los inmigrantes obtener ayuda para pagar las primas y/o los costos compartidos para el seguro de salud en los mercados de seguros?

    FAQs

    Usualmente, la mayoría de los inmigrantes legalmente presentes pueden obtener subsidios para ayudar a pagar las primas y los costos compartidos del seguro de salud obtenido en los mercados. Al igual que los ciudadanos, pueden calificar para créditos fiscales para primas que varían en una escala móvil basada en los ingresos. Por lo general, las personas deben tener ingresos por lo menos del 100% del nivel federal de pobreza ($15,650 para un individuo adulto o…

  • Los individuos a los que se les concedió Acción Diferida bajo el programa de Acción Diferida para los Llegados en la Infancia (DACA) ¿son elegibles para Medicaid, CHIP, y el mercado de seguros de salud?

    FAQs

    No. A algunos jóvenes que entraron al país de niños sin papeles se les otorgó un permiso temporal para permanecer en los Estados Unidos bajo el programa llamado de Acción Diferida para los Llegados en la Infancia (DACA). Estos individuos están legalmente en los Estados Unidos y pueden recibir permiso de trabajo y número de Seguro Social. Sin embargo, ya no son elegibles para Medicaid, CHIP, o el mercado de seguros de salud.