Health Costs

Health Care Affordability

Affordable Care Act

Updated Larry QT on ePTCs

There is No Drop-Dead Date for an ACA Tax Credit Extension, But Coverage Losses Will Mount as the Clock Ticks

While the Affordable Care Act’s enhanced premium tax credits expired at the end of 2025, there is no absolute drop-dead date for extending them. An extension could happen even after the deadline to sign up for coverage and be made retroactive to January 1. Open enrollment could also be extended to allow people time to change their plans or allow new people to sign up. ACA enrollees would welcome premium relief whenever it comes, explains KFF's Larry Levitt.

ACA Signups Are Down, But Still an Incomplete Picture

Data currently being released represent Open Enrollment ACA Marketplace plan selections, or how many people have signed up for or been automatically renewed into 2026 coverage. These data do not necessarily translate to enrollments. That is because people who have selected a plan or been automatically renewed may not ultimately choose to pay for their coverage, thus “effectuating” their enrollment.

KEY RESOURCES
  • Health Policy 101: Costs and Affordability

    This Health Policy 101 chapter explores trends in health care costs in the U.S. and the factors that contribute to this spending. It also examines how health care spending varies and the impact on affordability and people's overall financial vulnerability.  


  • Americans’ Challenges with Health Care Costs

    This data note reviews our recent polling data that finds that Americans struggle to afford many aspects of health care, including disproportionate shares of uninsured adults, Black and Hispanic adults and those with lower incomes.

  • National Health Spending Explorer

    This interactive Peterson-KFF Health System Tracker tool allows users to examine five decades worth of data on health expenditures by federal and local governments, private insurers, and individuals.

  • Polling on Prescription Drugs and Their Prices

    This chart collection draws on recent KFF poll findings to provide an in-depth look at the public’s attitudes toward prescription drugs and their prices. Results include Americans’ opinions on drug affordability, pharmaceutical companies, and various potential measures that could lower prices.

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  • Medicare Spending Cuts and Hospital Productivity Gains

    News Release

    In his latest column for The Wall Street Journal's Think Tank, Drew Altman and guest co-author Dana Goldman examine hospital productivity gains, and what they may mean for hospitals’ ability to absorb spending reductions. All previous columns by Drew Altman are available online.

  • Medicare Spending Cuts and Hospital Productivity Gains

    From Drew Altman

    In this column for The Wall Street Journal's Think Tank, Drew Altman and guest co-author Dana Goldman examine hospital productivity gains, and what they may mean for hospitals’ ability to absorb spending reductions.

  • Health Spending Is Rising More Sharply Again

    From Drew Altman

    In this column for The Wall Street Journal's Think Tank, Drew Altman discusses why high health care prices are a problem for consumers but not a cause of renewed growth in health spending.

  • Health Spending is Rising More Sharply Again

    News Release

    In his latest column for The Wall Street Journal's Think Tank, Drew Altman discusses why high health care prices are a problem for consumers, but not a cause of renewed growth in health spending. All previous columns by Drew Altman are available online.

  • Trends in Medicaid Spending Leading up to ACA Implementation

    Issue Brief

    This paper presents data on Medicaid spending during the years leading up to the implementation of the Affordable Care Act (ACA). It uses administrative data to first examine overall spending trends and trends by service type. We then draw on additional data to analyze per enrollee spending growth during this period, both by service type and by eligibility group, to understand what drove Medicaid spending.

  • New Reports Analyze Cost Sharing in 2015 ACA Marketplace Plans in 37 States

    News Release

    Charts Examine Savings from Subsidies at Stake in U.S. Supreme Court Case Cost-sharing subsidies under the Affordable Care Act can substantially reduce deductibles and other cost sharing for people with low incomes purchasing coverage in the federally-facilitated insurance marketplace serving 37 states, a new analysis by the Kaiser Family Foundation finds.

  • The Cost of Care with Marketplace Coverage

    Issue Brief

    This brief and accompanying slides examine cost sharing - deductibles, copayments and coinsurance - in 2015 insurance plans sold on the Affordable Care Act's (ACA) federally-facilitated marketplaces. The analysis looks at out-of-pocket limits, as well as cost sharing for hospital stays, physician visits, emergency room visits, and prescription drugs, for plans across the metal levels (platinum, gold, silver and bronze).

  • Medicare Spending Peaks at Age 96  

    News Release

    In his latest column for The Wall Street Journal's Think Tank, Drew Altman discusses the implications of a Kaiser finding: per capita Medicare spending peaks at age 96, and the main reason is not end-of-life care. All previous columns by Drew Altman are available online.

  • Medicare Spending Peaks at Age 96

    From Drew Altman

    In this column for The Wall Street Journal's Think Tank, Drew Altman discusses the implications of a Kaiser finding: per capita Medicare spending peaks at age 96, and the main reason is not end-of-life care.