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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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  • Summary of Key Changes to Medicare in 2010 Health Reform Law   

    Issue Brief

    Summary of Key Changes to Medicare in 2010 Health Reform Law . This brief provides a detailed look at the improvements in Medicare benefits, changes to payments for providers and Medicare Advantage plans, various demonstration projects and other Medicare provisions in the law. It includes a timeline of key dates for implementing the Medicare-related provisions in the law.

  • Explaining Health Care Reform: What is Comparative Effectiveness Research?

    Issue Brief

    The brief examines current funding for comparative effectiveness research, the provisions included in the current health reform legislation, and issues related to which treatments that might be studied, whether and how to weigh costs of care, and how such findings will be used and shared with health-care practitioners and the public. It is part of the Foundation's series of Explaining Health Reform briefs on key concepts in health reform. Brief (.pdf)

  • Physician Workforce: The Next Generation

    Event Date:
    Event

    The new health reform law poses questions about how the increase in the insured population will affect the demand on the health care workforce. Will it increase the shortage among primary care physicians? What about specialists? How much of the workforce shortage can be alleviated by payment incentives in the new law for both primary care and general surgery, and other new incentives to practice in underserved areas? Are there enough effective efforts in place…

  • Kaiser Health Tracking Poll: Election 2008 — March 2008

    Poll Finding

    Growing economic worries have led to a sharp rise in the economy as a campaign issue, eclipsing health on voters’ priority list, as well as Iraq. With economic concerns rising, where will health fit in the ongoing presidential campaign?  This March 2008 poll finds that health care plays a role in two ways: as an independent issue, and as part of the voters’ growing concerns about the economy. Health care ranks third as the issue…

  • 50 Ways to Implement Health Reform: State Challenges and Federal Assistance

    Event Date:
    Event

    This briefing looks into the key challenges facing states, including working within state legislative cycles against tight deadlines in the federal law, creating new roles at the state level as state budgets are being squeezed, and others. It looks at both near-term provisions, such as high risk pools, as well as other provisions farther down the road, such as setting up exchanges and instituting changes to Medicaid eligibility. This August 2 briefing was cosponsored by…

  • Implementing New Private Health Insurance Market Rules

    Issue Brief

    With the Jan. 1, 2014 effective date for implementing major changes in the private insurance market under the Affordable Care Act (ACA) approaching, this brief looks at three proposed federal regulations released in late November 2012 that detail how the ACA’s rules will operate in the following areas: private insurance market reforms, essential health benefits and actuarial value, and wellness programs offered or required by employers under group health plans. These regulations deal with aspects…

  • The Public’s Health Care Agenda for the 113th Congress

    Poll Finding

    As the 113th Congress is sworn in, and President Barack Obama begins his second term of office, a comprehensive new Kaiser Family Foundation/Robert Wood Johnson Foundation/Harvard School of Public Health survey queried the public about their priorities for, and views on, a wide range of health and health policy issues. These include issues that will preoccupy federal lawmakers, such as the role of Medicare in the deficit reduction debate, as well as issues currently being…

  • Kaiser Health Policy News Index: June 2014

    Feature

    This month's Health Policy News Index finds more than six in 10 say they followed news about long waiting lists for those seeking care at Veterans Affairs (VA) medical facilities closely. That makes the VA story the most closely followed health story in the first half of 2014, with slightly more people following it than followed several ACA enrollment stories earlier this year.

  • Pulling it Together: Duals: The National Health Reform Experiment We Should Be talking More About

    From Drew Altman

    The Center for Medicare & Medicaid Services (CMS) and 26 states are moving to launch a large scale managed care demonstration project potentially involving millions of the poorest, sickest, most expensive Medicare and Medicaid beneficiaries, the so-called dual eligibles. The experiment is getting more and more attention from policy experts, but with controversial issues like the survival of the Affordable Care Act and converting Medicare to a premium support program grabbing the limelight, it has…

  • Covering the Uninsured: Options for Reform

    Issue Brief

    Download PDF Key Facts on the Uninsured In 2007, 45 million nonelderly people in the United States lacked health coverage More than eight in ten uninsured people (81%) come from working families About two-thirds of the nonelderly uninsured are from low-income families (income below 200% of poverty, about $42,400 for a family of 4 in 2007) More than one in three people (35%) living in poverty are uninsured, compared with one in twenty people (5%)…