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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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  • Retiree Health Benefits At the Crossroads

    Report

    This issue brief reviews recent trends and developments in employer-sponsored retiree health coverage and examines the impact of recent legislation, such as the Medicare drug benefit and the Affordable Care Act (ACA) on retiree health coverage. The report describes leading strategies employers have been pursuing or considering to limit costs for retiree health benefits. In addition, the report considers the potential implications of proposals aimed at reducing federal spending for retiree health coverage and costs.

  • Measuring Changes in Insurance Coverage Under the Affordable Care Act

    Issue Brief

    This data note discusses the details and timing of some of the private and federal surveys that will be used to look at how coverage has changed due to the Affordable Care Act. Different surveys offer different information and insight into coverage under the ACA, and we discuss the contributions and challenges in each type of effort.

  • Analysis: Opportunities Under the ACA for Addressing Intimate Partner Violence Among Women With HIV

    News Release

    An estimated 36 percent of women in the U.S. report having experienced intimate partner violence (IPV), also called domestic violence, but among HIV positive women 55 percent report such experiences. A new Kaiser Family Foundation analysis looks at opportunities to address IPV in the Affordable Care Act (ACA) that could help women who are HIV positive or at risk for HIV. The analysis, HIV, Intimate Partner Violence and Women: New Opportunities Under the Affordable Care Act, looks…

  • The ACA Primary Care Increase: State Plans for SFY 2015

    Perspective

    This perspective provides additional information on state plans related to the Affordable Care Act's (ACA) primary care rate increase after the 100% federal financing ends December 31, 2014. The data in this report were collected as part of KCMU’s Annual Medicaid Budget Survey, conducted by Health Management Associates with the support of the National Association of Medicaid Directors,

  • Health Insurance Explained: The YouToons Have it Covered

    Video

    In this five-minute animated video, the YouToons help consumers understand their health insurance through fun, easy-to-understand explanations and scenarios. This cartoon serves as a tutorial for consumers and organizations. The YouToons previously appeared in the 2010 animated movie, "Health Reform Hits Main Street" and the 2013, "The YouToons Get Ready for Obamacare: Health Insurance Changes Coming Your Way Under the Affordable Care Act."

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

    Fact Sheet

    This state report explains how the ACA expands coverage in Texas, 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 Texas are eligible for Medicaid or financial assistance in…

  • 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 California Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in California, 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 California are eligible for Medicaid or financial assistance in…

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

    Fact Sheet

    This state report explains how the ACA expands coverage in Delaware, 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 Delaware are eligible for Medicaid or financial assistance in…