Yves here. This post if anything appears to understate the severity and knock-on effects of big ACA premium increases combined with the loss of Covid-era additional subsidies Even former CIA officer turned whistleblower John Kirakou said on one of his programs that he would no longer be able to afford coverage. It will takes some time for the policy abandonment and data on that to come in, but I suspect it will be worse than widely assumed. The article below does report on current enrollments, which fell in January, but also notes that some policy-holders may lose coverage by not paying on time.
By Julie Appleby. Originally published at KFF Health News
Most people who get their health coverage through the Affordable Care Act say they face sharply higher costs, with many worried they will have to pare back other expenses to cover them, according to a poll released Thursday. Some are uncertain whether they will be able to continue paying their premiums all year.
Still, 69% of those enrolled last year signed up again this year, often for less generous coverage. About 9% said they had to forgo insurance, according to the survey by KFF, a health information nonprofit that includes KFF Health News.
The KFF poll revisited the people who responded to a November KFF survey of Affordable Care Act enrollees during open enrollment for ACA plans.
Steve Davis, a 64-year-old retired car salesman in Rogersville, Tennessee, who participated in both polls, said he was looking at an annual premium of about $14,000 to renew his ACA coverage this year. He didn’t qualify for enough of a tax credit to defray the cost, he said, after Congress gridlocked on an extension of more-generous subsidies put in place under President Joe Biden.
But things worked out for Davis. He landed a job at a convenience store that came with insurance, with his share costing about $100 more a month than the $300 he paid for an ACA plan last year, before the enhanced tax credits expired.
“As it happened, the Lord provided and my insurance kicked in through my employer,” he told KFF Health News.
In the November survey, many respondents were not sure what they would do for their health insurance in the coming year.
Some were waiting to see whether Congress would extend the enhanced premium subsidies, which had helped many people get lower-cost — or even zero-cost — health premiums.
Congress’ inaction left some consumers in a bind.
Now, the new poll found, affordability issues are hitting home as the midterm election approaches. And that might play a role in competitive districts, creating headwinds for Republicans.
Midterm Signals
Across all respondents who were registered to vote, the poll found more than half place “a lot” of blame for rising costs on Republicans in Congress (54%), with a similar share putting the same level of blame on President Donald Trump (53%). A smaller group placed a lot of the blame on congressional Democrats (34%). Among independents, a group expected to be a key factor in many districts, the percentages putting a lot of the blame on the GOP (56%) and Trump (58%) were higher.
Among Republicans, 60% placed a lot of the blame on Democrats in Congress.
“Those who have marketplace coverage, who remained on it, they’re really struggling with health care costs,” said Lunna Lopes, senior survey manager for KFF.
While more than half (55%) of returning ACA enrollees said they will have to pare back on other household expenses to cover health care costs, about 17% said they might not be able to continue paying insurance premiums throughout the year.
Overall, 80% of those who reenrolled for 2026 said their premiums, deductibles, or other costs are higher this year than last, with 51% saying they are “a lot higher.”
About three-quarters of ACA enrollees in the survey who were registered voters said the cost of health care will have an impact on their decision to vote — and on which party’s candidate they support.
Democrats were more than twice as likely as Republicans to say those costs will have a major impact on their decision.
“Democrats seem particularly more energized by health care costs than their Republican counterparts,” Lopes said.
Enrollment Tally Down
Data released Jan. 28 by federal officials showed that about 23 million people enrolled in Obamacare plans across the federal healthcare.gov marketplace and those run by states, about 1.2 million fewer than in 2025.
But it isn’t yet known how many are paying their monthly premiums on time, and many analysts expect overall enrollment numbers to fall as that data becomes available in the coming months.
For most people, having to pay more for premiums this year was mainly due to the expiration of the enhanced tax cuts, pollsters noted. Because the subsidies that remain are less generous, households have to pay more of their income toward coverage. Congressional inaction also meant the restoration of an income cap for subsidies at four times the poverty level, or $62,600 for an individual, sticking people like Davis with higher bills.
Not everyone saw increases.
Matthew Rutledge, a 32-year-old substitute teacher in Apple Valley, California, who participated in both KFF polls, said he qualified as low-income and his subsidies fully offset his monthly premium payment, just as they did last year. He does have copayments when he sees a doctor or accesses other medical care, but he told KFF Health News that “as long as the premium doesn’t go up, I’m fine with it.”
Rising premiums are fueled by a variety of factors, including hospital costs, doctors’ services, and the prices of drugs.
To lower premiums, insurers offer plans with higher deductibles or copayments. In the ACA, plans with lower premiums but higher deductibles are called “catastrophic” or “bronze” plans. “Silver” plans generally balance premiums and out-of-pocket spending, while the highest-premium plans with lower deductibles are “gold” or “platinum.”
About 28% of those who stayed in the ACA marketplaces switched plans, the pollsters noted.
One 56-year-old Texas man told pollsters that his family’s income exceeded the cap for subsidies, so they switched down from a gold plan to a bronze. “Even doing that, our premiums are three times what they were in 2025, with lower plan features and a higher deductible,” he said, according to a KFF poll news release.
For some, reenrolling was not a viable option.
In addition to the 9% who said they are now uninsured, about 5% said they switched to some type of non-ACA coverage.
Some people, like Davis, landed job-based coverage, while others found they qualified for Medicaid, the joint state-federal program for low-income residents.
Such churn in and out of ACA coverage is not unusual, Lopes noted. “People get a job. They get married. They age into Medicare,” the program for older or disabled people, she said.
The poll highlighted that many people dropping coverage were younger, between 18 and 29. About 14% of people in that range now say they are uninsured.
That’s not surprising, given that younger people tend to use health coverage less. ACA insurers said one reason they raised premiums this year was because they expected more young or healthy people to drop out, leaving them with a higher share of older, more costly enrollees. Among those 50 or older, the poll found that only 7% are now uninsured.
GOP critics of the now-expired enhanced subsidies say they were always meant to be temporary. Extending them would have cost about $350 billion from 2026 to 2035, according to the Congressional Budget Office.
But not extending them means more people will become uninsured. The CBO said the extension would have meant 3.8 million more people having insurance coverage in 2035.
KFF pollsters, in February and early March, surveyed 1,117 U.S. adults, more than 80% of the ACA enrollees originally polled in November, online and by telephone. The margin of error is plus or minus four percentage points for the full sample.
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Thanks Obama.
My Obamacare provider jacked up premiums by more than 30%, but my premiums actually went down because I switched to an even scammier company called Oscar, affiliated with Jared Kushner and his brother Joshua.
Based on ten years of experience, the details of the coverage don’t matter much. The only thing that matters is that if you have an Obamacare plan, a hospital system will basically charge you whatever the out-of-pocket maximum is (around $10,000) for whatever procedures you need . If you don’t have an Obamacare plan, they charge $50,000 and up for the same services.
I expect the Republicans to get smoked in the midterms for a whole host of reasons, but please keep in mind that the Democrats are not actually better.
When I look at these prices, I can never understand Americans who ask, “How can we afford Medicare for All? or say, We don’t want to pay for other people’s healthcare. There just isn’t any critical thinking.
Meanwhile, Trump has just announced he wants $200 billion for Iran war, Jared Kursner is going to make a killing it’s not just the USA government that poses a danger to other countries it’s also the American public. Many hold an extremist capitalist mindset that prioritizes profit over people and they spread this mindset overseas
Just gotta say, “As it happened, the Lord provided and my insurance kicked in through my employer” is a helluva sentence, especially in regards to paying $100 more per month via your job in a convenience store.
Only in America.
right, and having to put off retirement to take said job.
Put off retirement? In 2026 that is retirement.
I realize that most people with employer coverage do not get how much of a scam the insurance is even if they do get that healthcare is also vastly overpriced.
But I will always despise Obama and the Democrats for their insurance bail out disguised as healthcare reform. A reform that made already expensive healthcare in America even more expensive. That opened doors for even more rentier pillaging. Those bought pieces of bovine feces enriched themselves at the expense of people’s life.
If they had done real healthcare reform, had passed single payer (including vision and dental) with real rules and penalties for abuse of system including jail terms for corporate officers, ie sending a Rick Scott to prison for ripping it off, this wouldn’t be happening today. I truly believe that all but the biggest ideologues and those who looked at health care as their means to enrich themselves by millions would have realized that government healthcare actually meant freedom from worry about an emergency visit to a hospital or dentist and the ability to take care of themselves without going into debt.
I am sick to death of Democrats using this or that crisis to showboat and fundraise, when they had had the ability in the past to eliminate the problem before it became a problem.
None of that absolves the Republicans. Both groups are rotting stench who work hard to pick up the tips their donors bestow on them to make their theft and pillaging legal.
Funny that Republicans are blamed most. Not to say they don’t share blame for the murderous costs of healthcare in the US. But Obama Democrats borrowed the plan from the Heritage Foundation as the basis of their bill, for instance. Many don’t seem to notice the plan has been a failure, on Obama’s and the Democrat’s own terms. My memory of the of the whole sordid affair of the bill’s passage is filled with emphatic hand gestures showing how the Democrats were going to “bend the cost curve.” Aren’t they heavily implicated for enacting the ineffective market-based Republican plan?