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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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  • 2022 Survey of ACA Marketplace Assister Programs and Brokers

    Report

    This survey of Marketplace assister programs and brokers tracks the experiences of professionals signing people up for Affordable Care Act coverage. It also examines the role that these programs expect to play when the COVID-19 public health emergency (PHE) ends, potentially ending Medicaid eligibility for millions of Medicaid enrollees.

  • ¿Quién es elegible para recibir subsidios para las primas?

    FAQs

    Los subsidios para las primas están disponibles para ciudadanos estadounidenses y ciertos inmigrantes con residencia legal que adquieran cobertura en el mercado de seguros y cuyos ingresos sean al menos iguales al 100% del Nivel Federal de Pobreza (FPL) ($15.650 para un adulto soltero o $32.150 para una familia de cuatro) en 2026. Actualmente, los subsidios para las primas también están disponibles para inmigrantes con residencia legal con ingresos inferiores a $15.650 (100% del FPL…

  • The Implications of the Most Recent Challenge to the ACA’s Preventive Care Requirement Could Affect Millions

    News Release

    A new brief explains the implications of the most recent legal challenge contesting the Affordable Care Act’s (ACA) requirement that most private insurance plans cover specific preventive care items and services—such as contraceptive services and supplies, and cancer screenings—at no cost to patients. In Braidwood Management v. Becerra, two Christian-owned businesses and six individuals in Texas have challenged the legality of the preventive care mandates on constitutional grounds. The plaintiffs are also challenging the requirement…

  • Nine Changes to Watch in ACA Open Enrollment 2023

    Policy Watch

    The 2023 Affordable Care Act (ACA) Open Enrollment period will run from November 1, 2022 to January 15, 2023 in most states, longer in some state-based marketplaces. This policy watch examines nine changes that may affect what enrollees pay for coverage, the size of tax credits for those eligible, and other changes that could affect enrollees' experiences.

  • Strategies To Lower Drug Costs Top the Public’s Health Priorities for Congress

    News Release

    Against the backdrop of public concern about inflation and rising gas prices, proposals to lower what people pay out-of-pocket for drugs tops the public’s list of health care priorities for Congress, a new KFF Health Tracking Poll finds. Most (55%) of the public say inflation is the biggest problem facing the country. Fewer cite other issues such as the Russian invasion of Ukraine (18%), climate change (6%), the COVID-19 pandemic (6%), and crime (6%). The…

  • Analysis of 2015 Premium Changes in the Affordable Care Act’s Health Insurance Marketplaces

    Issue Brief

    This analysis provides an early look at premium changes for individuals in the health insurance marketplaces, created under the Affordable Care Act (ACA), in major cities across 15 states plus DC. Although premium changes vary across and within states, premium changes for 2015 in general are modest when looking at low-cost plans. On average, individuals will pay slightly less in premiums for the benchmark silver plan in 2015 than in 2014.