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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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  • ¿Cubren los planes del mercado la atención médica de reasignación de género? ¿Qué cambios han habido en los requisitos de cobertura?

    FAQs

    No necesariamente. La cobertura varía según el estado y el plan. Algunos estados, pero no todos, prohíben que los planes médicos excluyan la cobertura de la atención de afirmación de género. Pero incluso en los estados donde la cobertura es obligatoria, es posible que no todos los servicios de afirmación de género estén cubiertos. Por ejemplo, un plan podría cubrir la terapia hormonal, pero no la depilación láser. En los estados donde no se exige…

  • Traté de renovar mi mismo plan para el próximo año, pero la aseguradora dice que olvidé un pago y que no me permitirán continuar con la cobertura hasta que pague la prima que debo. ¿Pueden hacer eso?

    FAQs

    No. Las aseguradoras no pueden exigir a quienes adeudan primas atrasadas que paguen la deuda antes de renovar la cobertura por un año más. Debe tener autorización para renovar, y el pago del 1 de enero no se podrá aplicar a la prima atrasada que adeude. De ahora en adelante, tenga en cuenta que las aseguradoras pueden cancelar su cobertura si no paga las primas. Si recibe subsidios para las primas por anticipado (APTC), las…

  • New Analysis Finds US Individual Insurance Market Grew 46 Percent in First Full Year of Affordable Care Act

    News Release

    A new analysis from the Kaiser Family Foundation finds that the nation's individual insurance market grew 46 percent to 15.5 million people in the first year plans could be purchased through the Affordable Care Act's marketplaces, which offer premium assistance to low- and moderate-income people. Four states -- California, Florida, Texas and Georgia -- accounted for almost half of the enrollment growth. In six states, the number of people covered in the individual market increased…

  • Access to Care for the Insured and Remaining Uninsured: A Look at California During Year One of ACA Implementation

    Issue Brief

    California is a bellwether state for understanding the impact of the Affordable Care Act (ACA). Much attention has been paid to enrollment in California's new coverage options, such as the Medicaid expansion (Medi-Cal) and plans sold through ACA marketplaces (Covered California), and to changes in the uninsured from 2013 to 2014. However, less is known about how this coverage has affected people’s access to care and financial security, and why others remain uninsured. This report,…

  • Round 2 on the Legal Challenges to Contraceptive Coverage: Are Nonprofits “Substantially Burdened” by the “Accommodation”?

    Issue Brief

    The Affordable Care Act (ACA) requires most private health insurance plans to provide coverage for a broad range of preventive services including Food and Drug Administration (FDA) approved prescription contraceptives and services for women. Since the implementation of the ACA contraceptive coverage requirement in 2012, over 200 corporations have filed lawsuits claiming that including coverage for contraceptives or opting for an “accommodation” from the federal government violates their religious beliefs. This brief explains the legal…

  • Are More Americans Benefiting From Obamacare Than Realize It?

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman discusses why many people may not know whether or not they are benefiting from the Affordable Care Act. All previous columns by Drew Altman are available online.

  • How Will the Uninsured in Alabama Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in Alabama, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Alabama are eligible for Medicaid or financial assistance in…

  • How Will the Uninsured in Hawaii Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in Hawaii, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Hawaii are eligible for Medicaid or financial assistance in…

  • How Will the Uninsured in Indiana Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in Indiana, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Indiana are eligible for Medicaid or financial assistance in…