Impact of ACA Premium Tax Credit Expiration on Healthcare Costs
KFF, a leading organization in health policy research, recently released a survey highlighting changes in health care costs for enrollees of Affordable Care Act (ACA) Marketplace plans. The findings underscore the financial impact experienced by individuals following the expiration of enhanced premium tax credits, as initially surveyed in 2025.
The survey reveals that over half (51%) of respondents reported significant increases in healthcare expenses, including rising premiums. Furthermore, 80% of participants experienced an increase in overall costs, encompassing premiums, deductibles, and additional out-of-pocket expenses. This financial strain is largely attributed to the expiration of tax credits, resulting in a substantial rise in annual premium payments for many who retained their Marketplace plans.
Faced with climbing costs, more than half (55%) of the respondents have reduced spending on essential household items, such as food, to manage their healthcare expenses. This trend is particularly pronounced among individuals with chronic health conditions, with 62% reporting similar measures. Concerns regarding the affordability of both anticipated and unforeseen medical costs are prevalent, with 73% worried about emergency and hospital care costs, and nearly half expressing concern about routine medical visits and prescription drug expenses.
The survey also indicates that about 10% of enrollees have opted out of ACA coverage due to escalating costs. Meanwhile, 28% have switched to different Marketplace plans to seek more affordable options. Respondents shared testimonies about the financial pressure stemming from the cessation of subsidies, with some choosing lower-tier plans that, despite offering reduced benefits, resulted in higher premiums due to changes in income levels.
Approximately 69% of the 2025 Marketplace participants have remained with ACA plans, while others have transitioned to employer-based insurance, Medicare, or Medicaid. A smaller faction has moved to non-Marketplace coverage options, which often provide limited benefits, typically influenced by changes in employment or personal circumstances.
Lastly, enrollees attribute rising health care costs to various stakeholders, including health insurers and pharmaceutical firms. The financial implications of healthcare burdens have also emerged as a pivotal factor in voting decisions, with many participants stating that these costs significantly influence their electoral choices.