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Affordable Care Act

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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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  • Pulling it Together: Implementation

    Perspective

    When I was a graduate student at MIT my adviser Jeffrey Pressman was a great political scientist who had just written the seminal book on program implementation.  It was called, simply enough, Implementation, with a subhead that read: "how great expectations in Washington are dashed" (OK, we political scientists study politics too much and are a little cynical at times).  The book literally created a new subfield in political science focusing on program implementation.  This…

  • The Massachusetts Health Care Landscape

    Fact Sheet

    This fact sheet summarizes the Massachusetts health care landscape, including data on demographics, population health, the uninsured and the state Medicaid program. Fact Sheet (.pdf)

  • Quick Take: Timing Matters: States Waiting for a Supreme Court Decision to Plan an Exchange

    Fact Sheet

    State-based health insurance exchanges are an important component of the Patient Protection and Affordable Care Act (ACA) designed to extend subsidized private health insurance coverage to millions of Americans by 2014. Though projections show exchange enrollment could grow to 20 million individuals nationally, aggressive planning on the part of states will be necessary to meet implementation timelines—exchanges must be fully operational by January 1, 2014 and the Department of Health and Human Services will begin…

  • Quick Take: Essential Health Benefits: What Have States Decided for Their Benchmark?

    Fact Sheet

    Beginning on January 1, 2014, the Affordable Care Act (ACA) requires that all non-grandfathered individual and small group health insurance plans sold in a state, including those offered through an Exchange, cover certain essential health benefits (EHBs). As it stands today, many plans offered in the individual and small group markets lack access to key benefits; the Department of Health and Human Services (HHS) estimates that 62% of health plan enrollees in the individual market…

  • Workplace Wellness Programs Characteristics and Requirements

    Issue Brief

    This issue brief summarizes what’s known about workplace wellness programs offered by employers today and the use of financial incentives to encourage workers to participate. Findings are drawn from the KFF/HRET Annual Employer Health Benefits Survey. In addition, the brief reviews proposed changes by the Equal Employment Opportunity Commission (EEOC) in federal standards governing financial incentives by workplace wellness programs and how these changes might balance the use of incentives against other discrimination and privacy…

  • The Affordable Care Act Doesn’t Rank Highly As an Issue for Voters in the Presidential Primaries

    News Release

    Despite Anecdotal Reports about Narrow Networks, 87% of Working-Age Adults with Insurance Are Satisfied With Their Plan's Choice of Doctors; 12% Say They Had to Change Doctors in Past Year As the ACA's Open Enrollment Nears End, Most of Those Who Remain Uninsured Are Disengaged While this month Congress passed and President Obama vetoed legislation to repeal the Affordable Care Act, voters nationally aren't focused on the law in this year's presidential election, the latest…

  • What New Data Tell Us About Doctor Choice

    News Release

    Is choice of doctors eroding? Drew Altman explores the rhetoric versus reality and why the issue resonates with Americans, in his latest column for The Wall Street Journal's Think Tank. All previous columns by Drew Altman are online.

  • Medicare-for-All vs. Single Payer: The Impact of Labels

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, “Medicare-for-All vs. Single Payer: The Impact of Labels”, Drew Altman uses new polling on a Medicare-for-all or single payer health system to explain how what you call a health reform plan can substantially affect the public’s response. All previous Drew Altman columns are online.

  • Assessing ACA Marketplace Enrollment

    Issue Brief

    This analysis examines factors that may have kept 2016 enrollment in Affordable Care Act (ACA) marketplace plans from reaching early projections, and it estimates that sign-ups will continue to grow modestly in coming years.

  • New Analysis Suggests ACA Marketplace Enrollment Could Grow Modestly Over Next Few Years, up to 16.3 Million Sign-Ups, 14.7 Million Enrollees after Attrition

    News Release

    A new analysis from the Kaiser Family Foundation finds that sign-ups in Affordable Care Act marketplace plans could continue to grow modestly over the next few years to 16.3 million (up 28%), based on the experience of the top-performing states. Assessing ACA Marketplace Enrollment examines factors that may have kept enrollment in 2016 from reaching early projections, including smaller declines than expected in employer coverage and a substantial number of people buying their own insurance…