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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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  • The Role Of Health Care In The 2020 Election

    Interactive

    This interactive map highlights what voters from the 2020 general election and Democratic primary voters said about health care as they vote, based on KFF's analysis of the state-level AP VoteCast data collected in most states. The primary election data also includes state-specific charts highlighting where health care ranks as issue, views about a single-payer health plan and a public option, and other health care findings from the AP VoteCast data with key demographic breakouts.

  • Millions of Uninsured Americans are Eligible for Free ACA Health Insurance

    Policy Watch

    Amid the ongoing pandemic and high unemployment, this poste xamines how many uninsured people would be eligible for free health insurance during in a typical year, including those who qualify for Medicaid or for tax credits that cover the full cost of an ACA Marketplace plan.

  • For 3rd Year in a Row, More Insurers are Entering the ACA Marketplaces, Creating More Options for Consumers

    News Release

    For the third straight year, more insurers are entering the Affordable Care Act’s marketplaces and expanding their service areas, creating more options for consumers seeking to buy their own insurance for 2021, a new KFF analysis finds.  The analysis finds 30 insurers joining the marketplace across 20 states, and another 61 insurers are expanding their services within states that they already served. More than a third of counties (1,207, or 38%) will have more insurers…

  • Insurer Participation on the ACA Marketplaces, 2014-2021

    Issue Brief

    For the third straight year, more insurers are entering the ACA Marketplaces or expanding their service area in 2021, creating more choices for consumers shopping for coverage during the 2021 open enrollment period.

  • 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…

  • 10 Reasons to Pay Attention to ACA Open Enrollment in 2020

    Policy Watch

    Whether new to the market or reenrolling, everyone who wants 2021 coverage through the ACA Marketplace must sign up during Open Enrollment. Here, we detail ten ways in which the 2021 ACA open enrollment period differs from enrollment periods in past years.

  • Pre-Existing Condition Prevalence Among Women Under Age 65

    Issue Brief

    We analyzed data from the 2018 National Health Interview Survey (NHIS) and 2018 Behavioral Risk Factor Surveillance System (BRFSS) to calculate prevalence rates of declinable health conditions. This data note looks at the share of adults ages 18-64 with declinable pre-existing conditions, with a particular focus on women.

  • Tracking Section 1332 State Innovation Waivers

    Fact Sheet

    This interactive map shows the status of all Section 1332 waivers requested by states. The Affordable Care Act (ACA) allows states to apply for innovation waivers to alter key ACA requirements in the individual and small group insurance markets and can be used to shore up fragile insurance markets, address unique state insurance market issues, or experiment with alternative models of providing coverage to state residents.