Impact of ACA Marketplace Changes on Coverage and Costs in 2025-2026

According to a survey conducted by KFF, nine percent of individuals who had ACA Marketplace coverage in 2025 are now uninsured. The survey highlighted healthcare costs as a significant factor for individuals who either switched plans or discontinued coverage altogether. Conducted from February 12 to March 2, the survey included 1,117 U.S. adults initially part of a larger 2025 study with 1,350 respondents.

The survey assessed the impact of the expiration of enhanced premium tax credits on healthcare costs. After these credits expired at the end of 2025, the follow-up study revealed that ten percent of those insured through the ACA Marketplace are now without coverage. Furthermore, 28% moved to different plans, primarily due to increased costs rather than health needs.

Among participants who continued their Marketplace coverage, 51% reported significantly higher healthcare costs in 2026. Additionally, 80% noted increased premiums, deductibles, or copays compared to 2025. Concerns about affording emergency care or hospital visits were voiced by three-quarters of returning enrollees, and nearly 70% re-enrolled for 2026, though some switched plans due to rising costs.

Regulatory and Market Developments

In related developments, healthcare leaders will engage in a roundtable discussion in Chicago from November 17-19 to explore regulatory changes and value-based care. Additionally, Colorado Access plans to enter the state's ACA market in 2027, while a potential Medicaid expansion in ten states could impact 2.3 million individuals.