Rising Healthcare Costs Amid ACA Marketplace Insured Americans

Priscilla Brown, a truck dispatcher from Orlando, Florida, faces increasing difficulties managing her Type 2 diabetes due to escalating healthcare costs. To manage financially, she sometimes reduces her insulin dosage or skips medication altogether. "Sometimes I don't even take my medicine," Brown explained, underscoring her struggle with high insurance expenses.

A recent KFF survey revealed that 80% of Americans with Affordable Care Act (ACA) marketplace insurance report higher healthcare costs this year. Approximately half of these individuals noted the costs are "a lot" higher, a sharp increase attributed to the expiration of enhanced tax credits on December 31, which previously helped lower premiums.

As a result of these rising costs, 55% of ACA marketplace enrollees surveyed in 2025 are considering cutting back on essentials such as food and household goods. Last year's congressional efforts to sustain COVID-era subsidies were unsuccessful, leaving around 23 million enrollees without financial relief.

The KFF poll, which included 1,117 Americans with ACA marketplace coverage between February 12 and March 2, 2026, highlighted that many Americans are increasingly anxious about managing unexpected medical expenses. Approximately 75% express concerns about emergency care costs, while nearly 50% are worried about the expenses of routine medical visits or medications.

Despite the cost increases, about 70% of ACA enrollees retained their coverage, although some switched plans within the marketplace, became eligible for employer-sponsored insurance, Medicare, or Medicaid, or opted for insurance outside the ACA marketplace. However, around 10% have completely dropped their insurance.

For some, the rising premiums are unsustainable. Eric LeVasseur, a software developer from Seal Beach, California, discovered his mid-tier silver plan was set to increase almost threefold to $1,200 per month. "It was not something my budget could absorb," he remarked.

The survey results indicate a significant portion of respondents blame health insurance companies for the increased expenses, with about 70% attributing substantial responsibility there. Politically, respondents varied in their attributions of blame, pointing fingers at opposing parties, lawmakers, and pharmaceutical companies. The KFF survey provides insight into how individuals are adapting to changes in healthcare costs and insurance coverage, highlighting ongoing issues and societal impacts.