What's Pushing Americans To Rethink Affordable Care Act Plans This Year?

(MENAFN- Live Mint) A new survey shows a sharp rise in healthcare costs for Americans enrolled in Affordable Care Act (ACA) Marketplace plans following the expiration of enhanced premium tax credits.

And, nearly one in 10 Americans enrolled in ACA plans last year have dropped their coverage in 2026, according to the new survey by AFF, highlighting the growing impact of rising healthcare costs.

About 51% of returning enrollees said their healthcare costs are“a lot higher” this year compared to 2025, including four in 10 who reported significantly higher premiums. Overall, 80% of respondents said their healthcare expenses-covering premiums, deductibles, co-pays, and coinsurance-have increased.

Costs spike after tax credit expiry

The findings come after the expiration of enhanced premium tax credits at the end of 2025, which had helped reduce monthly premiums for around 22 million Americans. Congress has not extended these subsidies.

Affordability concerns deepen

The survey found that 17% of returning enrollees are not confident they will be able to afford their premiums this year. For those who retained the same plans, the expiration of enhanced tax credits has more than doubled annual premium payments on average.

Households cutting essentials

Rising healthcare costs are forcing difficult financial trade-offs. Among those who re-enrolled:

-55% said they have cut or plan to cut spending on food or basic household needs

-The figure rises to 62% among those with chronic health conditions

Widespread anxiety over medical bills

Concerns about affordability remain high:

-73% are worried about emergency care or hospital costs

-49% are concerned about routine medical expenses

-45% worry about affording prescription drugs

Coverage changes driven by costs

The survey found that 9% of Marketplace enrollees are now uninsured, while 69% re-enrolled in ACA plans. Among those who stayed:

-39% kept the same plan

-29% switched plans

Meanwhile, 22% opted for alternative coverage, including employer-sponsored insurance, Medicare, Medicaid, or plans outside the Marketplace.

Others shifted to:

-Employer-based insurance (5%)

-Medicare (4%)

-Medicaid (7%)

-Non-Marketplace plans (5%), often with fewer protections

Political blame ahead of midterms

Among those facing higher costs:

-70% blame health insurance companies“a lot”

-54% blame Congressional Republicans

-53% blame Donald Trump

-52% blame pharmaceutical companies

Independents were more likely to assign significant blame to Republicans and Trump than to Democrats.

Survey methodology

The survey, conducted from February 12 to March 2, 2026, included 1,117 US adults who had ACA Marketplace coverage in 2025. It was carried out online and via telephone in English and Spanish, with a margin of error of ±4 percentage points.

Key takeaway

The findings highlight growing financial strain on ACA enrollees following the rollback of pandemic-era subsidies, with rising premiums forcing households to cut essential spending and reshaping coverage decisions ahead of the US midterm elections.

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