ACA Enrollees Cutting Costs Amid Rising Health Care Expenses

New poll shows many are sacrificing basic needs to afford coverage and care

Mar. 19, 2026 at 7:06pm

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A new survey from the KFF health research nonprofit found that about 8 in 10 Americans who re-enrolled in Affordable Care Act marketplace coverage say their health care costs are higher this year, including about half who say their costs are 'a lot' higher. This is largely due to the expiration of enhanced tax credits that had offset premiums for most enrollees. As a result, many are making difficult choices, with about 55% of respondents saying they're planning to cut spending on food and other basic household needs to deal with the higher costs.

Why it matters

The end of the COVID-era subsidies has left millions of ACA enrollees facing tough decisions about their health care and basic needs. This highlights the ongoing challenges of making affordable health coverage accessible, especially for lower-income Americans who rely on the ACA marketplace.

The details

The KFF poll found that about 1 in 10 of last year's ACA enrollees said they dropped coverage altogether and are now uninsured, while about 3 in 10 changed plans within the marketplace. Many respondents, like Priscilla Brown in Orlando, are having to choose between managing their health conditions and affording other necessities. Brown said she sometimes takes only a partial dose of her insulin to stretch it out longer.

  • The enhanced ACA tax credits expired on December 31, 2025.
  • The KFF poll was conducted from February 12 to March 2, 2026.

The players

Priscilla Brown

A 48-year-old truck dispatcher in Orlando, Florida who has had to make difficult choices between managing her Type 2 diabetes and affording other basic needs like gas for her car.

Eric LeVasseur

A 63-year-old software developer in Seal Beach, California who dropped his ACA coverage altogether when his monthly premiums nearly tripled to $1,200.

James Mako

An engineer in Boca Raton, Florida and political independent who downgraded his ACA plan to a bronze-level with a higher deductible when his $500-per-month premiums were poised to double.

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What they’re saying

“Sometimes I don't even take my medicine. It's so much with insurance, it's crazy.”

— Priscilla Brown

“When I saw my mid-tier, silver-level plan was going to nearly triple to $1,200 per month, it was not something my budget could absorb.”

— Eric LeVasseur

“I think they're just sales gimmicks. The subsidies should be back.”

— James Mako

What’s next

Democrats in Congress are continuing to push for a bipartisan compromise to restore the enhanced ACA subsidies, but it remains unclear if an agreement can be reached.

The takeaway

The end of the COVID-era ACA subsidies has left millions of Americans struggling to afford their health coverage and care, forcing many to make difficult trade-offs between their medical needs and other basic necessities. This highlights the ongoing challenges of ensuring accessible and affordable health care, especially for lower-income populations.