Impact of Rising Health Insurance Costs on ACA Coverage

Recent survey results indicate that rising health insurance costs have led some individuals to forgo their coverage. According to a study by health policy group KFF, 1 in 10 individuals who had Affordable Care Act (ACA) plans in the previous year are now without insurance. The expiration of additional federal subsidies earlier this year has contributed to a significant increase in premiums.

The survey, conducted in February and early March, involved 1,117 participants who were ACA plan holders last year. It assessed the impact of increased costs on coverage under the ACA. Of those surveyed, 69% retained their ACA plans, 9% became uninsured, and 22% switched to alternative coverage, such as employer-based insurance or Medicare. The primary reason for these changes was cost.

Cynthia Cox, a senior vice president at KFF, noted to The Wall Street Journal that the anticipated coverage loss aligns with expert predictions. Many ACA policyholders report higher expenses not only in premiums but also in copays, coinsurance, and deductibles. Approximately 17% of current enrollees are uncertain about affording their premiums throughout the year, suggesting potential future coverage drops.

To maintain their insurance, some families are reducing spending in other areas. More than half of respondents reported cutting back on essential expenses like food and clothing to afford health care. Some individuals are lagging on payments, with about 4% of ACA plan holders having not paid their premiums this year, although a 90-day grace period allows for continued coverage.

Specific instances highlight the financial strain, such as Florida's Kelly Rose, who dropped her ACA plan after premiums increased to around $1,700 monthly, surpassing her mortgage costs. While she had employer-offered insurance, she missed the enrollment deadline and is now purchasing necessary medications from a Canadian pharmacy at a reduced cost.

In the previous year, over 20 million individuals had ACA coverage. Sign-ups for 2026 saw a decrease to 23 million from the prior year's 24.2 million. Industry experts suggest that younger and healthier individuals are more inclined to drop coverage when prices increase. Some insurers, like CVS Health's Aetna, have exited the ACA market entirely.

The future of ACA subsidies remains uncertain and is likely to be a subject of discussion in upcoming election cycles.