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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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  • Corporate Leaders Are Getting Bullish On Government Action On Health Care Costs

    From Drew Altman

    In this Axios column, Drew Altman explores whether the long struggle with rising health costs has caused the tide to turn in corporate leaders’ attitudes towards government involvement in controlling health spending and whether it is part of a larger shift in comfort with government action to solve problems.

  • A Status Report on Prescription Drug Policies and Proposals at the Start of the Biden Administration

    Issue Brief

    This brief provides a status update on prescription drug final rules advanced by the Trump Administration in its final months related to Medicare, importation, and 340B pricing for insulin and epinephrine, and an overview of key drug pricing proposals related to Medicare and prescription drug prices generally that were voted on but not enacted in the previous Congress that may return to the forefront of health policy discussions in the coming years.

  • Survey: OBGYNs Report That the Affordable Care Act Has Increased Use of Contraceptives Among Patients, but the Cost of Reproductive Health Care Still a Burden for Their Low-Income Patients

    News Release

    This report highlights key findings from the 2020 KFF National Physician Survey on Reproductive Health that asked a nationally representative sample of OBGYNs practicing in the United States about a wide range of issues, including their provision of contraception, abortion, and STI care.

  • Escuché que hay una nueva oportunidad de inscripción especial para las personas de muy bajos ingresos. ¿Cómo funciona?

    FAQs

    Desde el 25 de agosto de 2025, se eliminó la oportunidad de inscripción especial que permitía a las personas con ingresos iguales o inferiores al 150% del nivel federal de pobreza inscribirse en la cobertura del mercado de seguros durante todo el año, simplemente por sus bajos ingresos. Las personas con este nivel de ingresos aún podrían calificar para la inscripción especial en otros eventos de inscripción especial, como cuando pierden la cobertura por pérdida…

  • Ten Changes to Watch in Open Enrollment 2022

    Issue Brief

    Even as the ninth annual Open Enrollment period gets underway, the Affordable Care Act (ACA) Marketplaces continue to evolve and important changes are expected. This issue brief discusses what changes to watch out for in the coming enrollment period.

  • 2021 Health Insurance Marketplace Calculator

    Interactive

    The Health Insurance Marketplace Calculator, updated with 2021 premium data and to reflect subsidies in the American Rescue Plan Act of 2021, provides estimates of health insurance premiums and subsidies for people purchasing insurance on their own in health insurance exchanges (or “Marketplaces”) created by the Affordable Care Act (ACA). With this calculator, you can enter your income, age, and family size to estimate your eligibility for subsidies and how much you could spend on…

  • Lacking Dental Coverage, Many People on Medicare Forgo Dental Care, Especially Beneficiaries of Color

    News Release

    Many people enrolled in Medicare go without dental care, especially beneficiaries of color, according to a new KFF analysis of dental coverage and costs for people with Medicare. Almost half of all Medicare beneficiaries (47%) did not have a dental visit within the past year as of 2018, the analysis finds, with rates higher among those who are Black (68%) or Hispanic (61%) compared to White beneficiaries (42%). Rates were also higher among those who…

  • Substance Use Issues Are Worsening Alongside Access to Care

    Policy Watch

    Drug overdose deaths rose during the early part of the COVID-19 pandemic, with some of the biggest jumps occurring among people of color. This analysis breaks out drug overdose deaths by race and ethnicity for the first nine months of 2020, to the same period in each of the two prior years. It also looks at access to care issues and recent and pending legislation aimed at addressing the nation’s substance use and mental health…