KFF Survey Highlights ACA Enrollees' Struggle as Enhanced Subsidies Face Expiration

A recent Kaiser Family Foundation (KFF) survey reveals growing financial strain among Americans enrolled in Affordable Care Act (ACA) marketplace plans due to the impending expiration of enhanced premium tax credits originally implemented during the COVID-19 pandemic. These credits have helped over 90% of enrollees manage monthly premiums; their expiration at the end of 2023 is projected to cause an average doubling of monthly payments, significantly impacting affordability for most beneficiaries. The survey finds that 60% of enrollees already struggle to cover out-of-pocket medical expenses, including deductibles and copays, while nearly half face challenges affording monthly premiums. Many enrollees express concern about the financial hardship posed by even modest increases in insurance costs, highlighting vulnerability among lower-income individuals and those with volatile incomes who constitute the majority of ACA marketplace participants. Survey data indicates that over half of enrollees expect substantial increases in health insurance costs for 2024, with notable examples of premium hikes exceeding several hundred dollars per month and rising out-of-pocket maximums. Despite these concerns, health insurance remains critical for accessing necessary care, especially for those managing complex medical conditions or disabilities. Political support for extending the premium tax credits exists across party lines among enrollees, with a strong majority favoring continuation; however, Congressional deadlock has left the extension uncertain amidst broader policy disputes and a recent government shutdown. Enrollees generally attribute responsibility for the potential lapse in support to Republican leaders and former President Trump more than to Democrats, though some call for bipartisan compromise. This looming policy change underscores the intersection of regulatory decisions, market stability, and consumer protection within the U.S. health insurance landscape, posing significant challenges for policymakers and insurance providers addressing affordability and access in the near term.