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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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  • What Iowa and New Hampshire tell us about Medicare-for-All

    From Drew Altman

    In this Axios column, Drew Altman analyzes data from the New Hampshire exit poll showing that support for Medicare-for-all played a role in the primary while broader support for a more moderate plan may be a signal about the general election.

  • A Conversation with Washington Gov. Inslee and Colorado Gov. Polis on the Public Option in Their States

    Event Date:
    Event

    On Friday, Feb. 7, KFF hosted a conversation with Colorado Gov. Jared Polis and Washington State Gov. Jay Inslee about their states’ efforts to establish a public health insurance option and make other changes to address health costs and access. The two governors have made health reforms a key part of their agendas and are seeking to expand access to affordable coverage for their residents through a public option – an approach that some national…

  • Health Issues and the Election Quiz

    Feature

    Test your knowledge about health facts, policy issues and proposals that are emerging among the 2020 presidential candidates. The 10 questions focus on health issues in the 2020 election, including: health care costs, prescription drug prices, the Affordable Care Act and changes in health insurance coverage, reproductive health, and Medicare-for-all and public option proposals.

  • Poll: Democrats Like Both the Public Option and Medicare-for-all, But Overall More People Support the Public Option, Including a Significant Share of Republicans

    News Release

    Lowering Drug Costs and Maintaining Pre-existing Condition Protections Top Public’s Health Priorities for Congress With the first votes of the 2020 Democratic presidential primary season approaching, large majorities of Democrats – and most of the public overall – support both of the major approaches primary candidates have put forward to expand coverage and make health care more affordable, though a public option remains significantly more popular than Medicare-for-all, the latest KFF Health Tracking Poll finds.…

  • Public Opinion on Women’s Health and Preventive Care

    Feature

    This slideshow draws on findings from a recent Kaiser Health Tracking Poll to provide an in-depth look at public opinion on women's health and preventive care. Results include Americans' awareness and attitudes toward Affordable Care Act provisions for women's health and preventive care, as well as the public's views toward federal funding for Planned Parenthood and reproductive health care for lower income women.

  • Medicaid: What to Watch in 2020

    Issue Brief

    Medicaid, the provider of health insurance coverage for about one in five Americans and the largest payer for long-term care services in the community and nursing homes, continues to be a key part of health policy debates at the federal and state level. Key Medicaid issues to watch in 2020 include: Medicaid expansion developments; Section 1115 waiver activity; enrollment and spending trends; benefits, payment and delivery system reforms, and the implications of the 2020 elections.

  • The ACA is Doing Fine Without a Mandate Penalty

    From Drew Altman

    In an Axios column, Drew Altman explains that the elimination of the Affordable Care Act’s individual mandate penalty has had little impact on how the ACA’s insurance markets are working, showing that “the marketplaces continue to function, even when 'severed' from the mandate penalty,” and undercutting a central argument in the lawsuit seeking to strike down the entire law.

  • Health Policy in 2020 Will Be Made in the States

    From Drew Altman

    With a questionable outlook for 2020 passage of legislation on prescription drug pricing and surprise medical bills, Drew Altman says the real action to watch in health policy is likely to be in the states.