At the end of 2025, many people using the Affordable Care Act (ACA) Marketplace faced tough choices. Enhanced premium tax credits, which helped reduce costs, expired. This led to rising premiums and overall health care costs for many enrollees. In late 2025, the Kaiser Family Foundation (KFF) surveyed 1,350 individuals enrolled in ACA plans to understand their feelings about these changes. A follow-up survey in 2026 targeted over 1,100 of those original participants, focusing on how they were coping with the expired tax credits.
Here’s the summary of the findings:
Costs Are Rising: A staggering 80% of returning enrollees reported their health care costs have increased this year. Half said these costs were “a lot higher” compared to last year. Many expressed concerns not just about premiums but also about deductibles and out-of-pocket expenses.
Financial Stress: For 55% of those who re-enrolled, health care costs are forcing them to cut back on basics like food and household items. This struggle is even more pronounced for individuals with chronic conditions, with 62% of this group feeling the financial pinch.
Changing Plans and Uninsured Rates: One in ten returning enrollees is now uninsured, while 28% have switched to different Marketplace plans primarily due to cost. A Texan shared their frustration, saying, “The prices are simply too high,” reflecting a common sentiment among many.
Impact on Voting: Healthcare costs are becoming a hot topic as the 2026 midterm elections approach. Almost half of the voters in the Marketplace say these costs will influence their voting choices. Notably, Democrats seem more affected by health care costs than Republicans, indicating a potential shift in voter priorities.
Feeling Worried and Angry: During the open enrollment process, most enrollees felt “worried” or “angry” about their insurance options, a stark contrast to the fleeting relief provided by subsidies in previous years.
To deepen this discussion, it’s important to note some expert insights. Healthcare economist Dr. Sarah Kliff emphasizes the long-term trend of rising healthcare expenses. She notes, “Americans will have to grapple with the increasing cost of health care for some time. The expiration of federal subsidies is a decision that resonates beyond politics; it impacts the daily lives of families.”
Statistics also highlight this trend. For instance, a recent report from the CDC indicated that health care expenditures have risen by 5.4% over the past year, underscoring financial challenges beyond the ACA Marketplace.
Public Sentiment: A 2023 public opinion survey revealed that 78% of those who rely on ACA coverage believe Congress made a mistake by allowing these enhanced credits to expire. Interestingly, this sentiment spans political affiliations, showing that concerns around health care costs are a unifying issue across party lines.
Overall, the landscape of health insurance and affordability in America remains complex and challenging, particularly for those reliant on Marketplace coverage. As enrollees navigate these rising costs, it’s clear their voices will echo in the upcoming election, potentially shaping future healthcare policy decisions.
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ACA Marketplaces,Affordability,Coverage,Enrollment,Health Care Markets,High-Deductible Plans,Prescription Drugs,Subsidies
