Many ACA Enrollees Struggle with Rising Health Costs After Subsidy Expiration

New poll shows Americans are cutting back on essentials to afford health care

Mar. 19, 2026 at 3:03pm

Got story updates? Submit your updates here. ›

A new KFF survey reveals that many Americans who had Affordable Care Act marketplace health insurance in 2025 are now facing significantly higher health care costs, with about half saying their costs are 'a lot' higher this year. The main reason cited is the expiration of enhanced tax credits that had offset premiums for most enrollees. As a result, some enrollees are switching to lower-tier plans, while others are dropping coverage entirely, and many are cutting back on basic household needs to afford their medical expenses.

Why it matters

The findings highlight the real-world impact of the expiration of the COVID-era ACA subsidies, which Democrats in Congress had fought to extend but faced pushback from Republican leadership. The poll offers a glimpse into how this unresolved political fight continues to strain regular Americans, even as lawmakers have turned to other priorities.

The details

About 8 in 10 Americans who re-enrolled in ACA 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 Dec. 31 expiration of enhanced tax credits that had offset premiums for most enrollees. As a result, around 55% of those surveyed said they're planning to deal with health care costs by cutting spending on food and other basic household needs. Some enrollees, like 63-year-old Eric LeVasseur, have even dropped coverage altogether after seeing their premiums nearly triple.

  • 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 is struggling to afford her Type 2 diabetes medication due to rising health care costs.

Eric LeVasseur

A 63-year-old software developer in Seal Beach, California, who dropped his ACA coverage after seeing his monthly premium nearly triple to $1,200.

James Mako

An engineer in Boca Raton, Florida, and a political independent, who downgraded his ACA plan to a bronze-level with a higher deductible due to rising costs.

KFF

A health care research nonprofit that conducted the survey on the impacts of the ACA subsidy expiration.

Got photos? Submit your photos here. ›

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, software developer

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

— James Mako, engineer

What’s next

Democrats in Congress are expected to continue pushing for a bipartisan compromise to reinstate the enhanced ACA subsidies, though the path forward remains uncertain.

The takeaway

The expiration of the ACA subsidies has put a significant financial strain on millions of Americans, forcing many to make difficult choices between affording their health care and meeting other basic needs. This underscores the ongoing political and policy challenges around ensuring accessible and affordable health coverage for all.