Rising Health Insurance Premiums in the ACA Marketplace: Trends and Impacts

As health insurance premiums continue to rise, many individuals are reassessing their coverage options within the Affordable Care Act (ACA) Marketplace. Jessica Chamberlain, an Illinois resident and single mother, witnessed her monthly premiums nearly double from $59.67 to almost $100. Confronted with this financial burden, Chamberlain chose to opt out of health insurance coverage.

The KFF survey published recently highlights a broader trend, showing approximately 10% of ACA Marketplace participants discontinuing their coverage in 2026. This drop correlates with increasing healthcare costs and the cessation of enhanced premium tax credits, which previously reduced expenses for around 22 million Americans but expired at the end of 2025.

The survey, which re-interviewed over 1,100 adults between February and March 2026, found that 69% of respondents re-enrolled in Marketplace plans. Of these, 39% retained their original plans, while 29% switched to different plans. However, more than half reported significantly higher healthcare expenses, including premiums, deductibles, and co-pays.

Cost was the primary reason cited by those who changed or discontinued their coverage. Holly Weir, an Ohio resident, canceled her UnitedHealthcare plan after her premiums increased from $30 to $177 monthly. Weir, a thyroid cancer survivor, now awaits Medicaid approval, a move driven by her ongoing healthcare needs and financial considerations.

The survey further revealed that to manage these increased healthcare costs, more than half of respondents who remained in the Marketplace had to reduce spending on essentials like food. This financial strain was even more pronounced among those with chronic health conditions.

Some individuals continued to explore other coverage options; 22% transitioned to plans through employers, Medicare, Medicaid, or alternative health plans outside the Marketplace. Chamberlain, addressing her situation, expressed the challenges faced by those with pre-existing conditions and emphasized the additional difficulties encountered by single parents.

These findings underscore the need for market participants to evaluate the evolving landscape of health insurance costs and coverage, particularly in light of changing federal subsidies and economic pressures facing consumers.