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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  • 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…

  • ACA Coverage and the Changing Labor Market: Voices from the Field

    Issue Brief

    This brief highlights voices from adult focus group participants with low and moderate incomes who gained Medicaid or Marketplace coverage following implementation of the ACA. It focuses on work, including work status, the new labor market, job benefits, and the role of ACA coverage for those with non-traditional jobs.

  • Updated for 2015: Tool Displays By Locality the Share of Potential ACA Federal Marketplace Enrollees That Signed Up

    News Release

    An interactive tool from the Kaiser Family Foundation is now updated with 2015 data, allowing users to view on a local level the share of potential enrollees who signed up for a health plan in a federally-based marketplace under the Affordable Care Act. With Mapping Marketplace Enrollment, users can also compare the number of potential and actual enrollees – and the percentage that signed up for a plan -- in 2014 and 2015 within 100,000-resident…

  • Women’s Health Issues Journal: Medicaid and Women’s Health Coverage Two Years into the Affordable Care Act

    Issue Brief

    As Medicaid marks its 50th year, the program has unquestionably become the mainstay of health coverage for low-income women in the nation. Since its inception, its role for women has continued to evolve and expand, but the passage of the Affordable Care Act (ACA) swung open the doors for Medicaid to serve even more low-income women who lack access to private or employer-based insurance. This is because the ACA enabled states to finally eliminate Medicaid's…

  • 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.

  • Web Briefing: Modern Era Medicaid and CHIP – Findings from a 50-State Survey of Eligibility, Enrollment, Renewal, and Cost-Sharing Policies

    Event Date:
    Event

    The Kaiser Commission on Medicaid and the Uninsured (KCMU) hosts a web briefing to present findings from our 13th annual 50-state survey of Medicaid and CHIP eligibility, enrollment, renewal, and cost-sharing policies. The survey provides a profile of where states stand as of January 2015, one year into the implementation of the major Medicaid provisions of the Affordable Care Act (ACA).

  • Visualizing Health Policy: Premium Changes in the Affordable Care Act’s Insurance Marketplaces 2014-2015

    News Release

    This Visualizing Health Policy infographic illustrates the change in monthly premiums by county, and select cities, from 2014 to 2015 for a 40-year-old person covered by the second-lowest-cost silver “benchmark” plan in the Affordable Care Act’s insurance marketplaces. Premium changes were greatest in Summit County, Colo. (45% decrease) and southeastern Alaska (34% increase), before tax credits. After accounting for tax credits, premiums for a 40-year-old person with an annual income of $30,000 would remain flat in…