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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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  • What is a Mini-Med Plan?

    Perspective

    One of the early insurance market changes in the Affordable Care Act (ACA) phases out caps that some insurance plans impose on the annual dollar amount of benefits they will cover. Plans issued or renewed after September 23, 2010 cannot have annual limits of less than $750,000, and the threshold goes up to $1.25 million in 2011. Annual dollar limits of any kind are prohibited starting in 2014. The federal government has issued waivers from…

  • Remember the People Outside of the Exchanges

    Perspective

    There has been a substantial amount of focus on the recently released draft regulations governing state-based health insurance exchanges under the Affordable Care Act (ACA). And that's appropriate, since the exchanges have the important roles under reform of providing consumers with easier access to insurance and facilitating tax credits and cost-sharing subsidies that make coverage more affordable. But, as central as exchanges will likely be, it's important to remember that there are other key provisions that help…

  • Non-Voters and Health Reform: Indifference and Confusion Over the New Law

    Perspective

    The latest Kaiser Health Tracking Poll assessed the role health reform played in voters’1 decisions in the midterm elections and the public’s overall mood towards the health reform law. This blog post focuses on a different group, people who say they are not registered or did not vote in last week’s election, and examines how their views on the health reform law differ from those that said they did vote. As is usually the case,…

  • Kaiser November Tracking Poll Finds Health Care a Factor in Congressional Election, But Not a Dominant One

    Perspective

    This month’s Kaiser Health Tracking Poll, conducted during the four days following the mid-term election, asked voters in an open-ended question to name in their own words the biggest factors influencing their vote for Congress, and found that health care was a factor, but not a dominant one. Among all voters, the factor mentioned most often was the economy/jobs (29%). The next two most mentioned factors were party preference (25%) and views of the candidates…

  • Health Affairs Issue Focuses on Health Reform

    Perspective

    The June 2010 issue of the journal Health Affairs is dedicated to health reform, and "begins to tackle the hundreds of implementation issues inherent in health reform and offers prescriptions for averting trouble," according to Editor-in-Chief Susan Dentzer. The issue features an article by Kaiser researchers examining past and present polling related to reform and showing how a surprisingly stable public opinion tracked with historic patterns, even if the contentious public debate suggested a volatile…

  • KFF Explores Health Reform and the Tea Party Movement

    Perspective

    With much media discussion of the role that the Tea Party will play in the upcoming congressional midterm elections, the Kaiser Family Foundation took a closer look at Tea Party supporters using its most recent Health Tracking Poll data from September. While 57 percent of voters who do not support the Tea Party movement view the health reform law favorably, 57 percent of Tea Party supporters view the law "very" unfavorably, and another 11 percent…

  • Kaiser December Tracking Poll: Public Remains Divided on Health Reform Law; Significant Number of People Struggle Financially

    Perspective

    As 2010 draws to a close, the latest tracking poll from the Kaiser Family Foundation shows the public still divided in their views of the health reform law, a sentiment largely unchanged since the law’s enactment in March. Forty-two percent of Americans say they have a generally favorable view of the law, while 41 percent have a generally unfavorable view of it. As the weak economy continues, the survey finds that a significant number of…

  • Public Opinion on Gender Rating

    Perspective

    With the Republican presidential primaries wrapping up, a barrage of new television commercials, radio ads, and fundraising emails has marked the start of the general election campaign. The Affordable Care Act (ACA) continues to be a mainstay election topic for candidates from both major parties. While Republicans focus on advocating repeal of the 2010 health care law, President Barack Obama and the Democratic Party have concentrated on the benefits of the law. And one lesser…

  • What Issues Are Most Important To Voters in This Election? The Answer Depends On The Question

    Perspective

    Election polling has entered hyperdrive, with several polls released daily. As Nov. 6 draws near, it is important to keep in mind that question wording and format do matter, sometimes quite a lot. In our October Kaiser Health Tracking Poll, we measured voters’ top issue priorities two ways: First, we asked one group to name the most important issue to their vote for president in an open-end question, allowing respondents to say in their own…

  • Private Insurance Benefits and Cost-Sharing Under the ACA

    Perspective

    The Department of Health and Human Services (HHS) recently released guidance on the two key components that determine the level of protection that private insurance plans will provide to consumers under health reform. The first involves the services that insurance plans must cover, and the second involves how much patients must pay out-of-pocket for those services. The Affordable Care Act (ACA) establishes new rules for what insurers must provide for both components starting in 2014.…