Dive Brief:
- Healthcare costs for enrollees buying coverage on the Affordable Care Act exchanges have increased significantly this year after more generous financial assistance for the health plans lapsed, and some people are becoming uninsured, according to a survey by health policy researcher KFF.
- Eighty percent of returning marketplace beneficiaries said premiums, deductibles and coinsurance are higher for their 2026 plan. More than half said their costs are “a lot higher,” according to the poll published Thursday.
- Some enrollees are choosing different health plans or dropping coverage altogether due to heightened costs. About 30% reported switching to a different marketplace plan, while around 1 in 10 are currently uninsured.
Dive Insight:
The survey shows early outcomes from the expiration of enhanced subsidies for ACA plans. Enacted during the COVID-19 pandemic, the premium tax credits expanded the number of enrollees who were eligible for the financial assistance.
The subsidies expired at the end of 2025 after Congress declined to extend them. Many Republicans argued the financial assistance was expensive and increased opportunities for fraud on the exchanges. Democrats pushed to preserve them, saying healthcare costs would spike for beneficiaries if they were allowed to expire.
Now, costs have increased for beneficiaries on the exchanges, and some enrollees are switching plans or cutting back on other expenses as a result, according to the survey by KFF, which interviewed more than 1,100 people.
Nearly 3 in 4 returning enrollees said they’re “very worried” or “somewhat worried” about being able to afford emergency care or hospitalizations. And nearly half are concerned about costs for routine medical care or prescription drugs.
Fifty-five percent said they would cut back on spending on food or other household items to afford their insurance and healthcare. More than 40% said they already have or are planning to find an extra job or work more hours to cover health expenses.
Still, high costs might push more beneficiaries to drop their coverage. One in six marketplace enrollees said they weren’t confident they could afford their monthly premiums for the whole year.
Most 2025 enrollees stay on the ACA exchanges, but some drop coverage
Rising healthcare costs could have political consequences for Republicans, according to the poll. While 70% of returning marketplace enrollees blamed insurers “a lot” for increased costs, at least half pointed to congressional Republicans and President Donald Trump.
Majorities of Democrat and Republican respondents placed blame on lawmakers from the opposite party. But 56% of independents blamed Republicans in Congress, and nearly 60% pointed to Trump. In comparison, only 28% of independents placed blame on congressional Democrats.
