​This issue brief explores trends in key data on the affordability of health coverage in California, to highlight both progress and remaining challenges to affordability on the state’s individual market under the ACA. The authors examine trends from 2013, the last year before full implementation of the ACA, to 2017, the most recent year for which key data are available. To put individual market affordability challenges in context, the authors compare the spending and cost burden experienced by those relying on the individual market to Californians with employer-sponsored coverage. The report uses 2013 and 2017 California Health Interview Survey (CHIS) data from individual-market consumers citing cost as a reason for delaying or forgoing health care to illustrate health care challenges.