1 in 10 ACA Enrollees Drop Coverage Due to Rising Costs: Poll

Expiration of premium tax credits leaves many struggling to afford health insurance

Mar. 19, 2026 at 6:48pm

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A new KFF survey found that nearly 1 in 10 people enrolled in the Affordable Care Act (ACA) Marketplace last year dropped their coverage in 2026 due to rising health care costs. The end of enhanced premium tax credits, which helped lower monthly premiums for 22 million Americans, has left many unable to afford coverage, with over half of returning ACA enrollees saying their health care costs are 'a lot higher' this year.

Why it matters

The findings highlight the ongoing challenges of making health care affordable, especially for those with pre-existing conditions or lower incomes who rely on the ACA Marketplace for coverage. The expiration of the premium tax credits, without action by Congress to extend them, has put health insurance out of reach for many Americans.

The details

The KFF survey found that 69% of respondents re-enrolled in Marketplace coverage, with 39% selecting the same plan and 29% switching plans. However, over half said their health care costs, including premiums, deductibles, co-pays, and coinsurance, are 'a lot higher' this year. Additionally, 9% of Marketplace enrollees dropped their ACA coverage and are currently uninsured. Respondents cited the rising costs as the primary reason for dropping or changing their coverage.

  • The KFF survey was conducted between February 2 and March 2, 2026.
  • The enhanced premium tax credits that helped lower monthly premiums expired at the end of 2025.

The players

Jessica Chamberlain

A 43-year-old mother of two from Illinois who decided to forego health insurance due to the nearly doubling of her monthly premiums under the ACA.

Holly Weir

A 26-year-old from Ohio who was paying $30 in monthly premiums last year but saw her plan increase to $177 per month, leading her to cancel her insurance and apply for Medicaid coverage.

KFF

A non-profit organization that focuses on national health issues and is the source of the survey on ACA enrollees dropping coverage.

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What they’re saying

“I can't afford that as a single mom with two kids.”

— Jessica Chamberlain

“Once that runs out, I'll get a lot more scared. Of course, I'm not going to be stupid and leave it so long. If it does come to it, I'll pay [for the insurance]. The idea that I would have to spend that each month is frustrating. I'm already not doing amazingly financially.”

— Holly Weir

“This is destroying people who have pre-existing conditions. It is affecting people, especially single moms. We're just trying to live.”

— Jessica Chamberlain

What’s next

Congress may consider legislation to extend or reinstate the enhanced premium tax credits that helped make ACA coverage more affordable for millions of Americans.

The takeaway

The expiration of the ACA's premium tax credits has left many Americans, especially those with lower incomes or pre-existing conditions, struggling to afford health insurance coverage, highlighting the ongoing challenges of ensuring access to affordable health care.