Returning marketplace enrollees are paying more for their 2026 ACA coverage and will cut back on spending; many not confident they can afford premiums all year.
The expiration of the enhanced premium tax credits for people with Affordable Care Act (ACA) Marketplace plans is exacting a toll on enrollees surveyed.
KFF, a nonprofit health policy research group, asked people it had surveyed in 2025, before the plan costs went up, again in 2026 about their experiences.
Half of returning enrollees say their health care costs are "a lot higher" this year compared to last year, including four in 10 who specifically say their premiums are "a lot higher." In all, a large majority (80%) of these enrollees say their health care costs, which can include premiums, deductibles, co-pays, or coinsurance, are higher. Most expect to reduce basic household expenses-including food-to afford coverage. About 9% of those surveyed dropped their marketplace coverage and are now uninsured. Three in 10 switched ACA plans, most citing high costs.
The latest survey found that 17% of returning Marketplace enrollees say they are not confident they will be able to afford their premiums this year.
The survey was conducted Feb. 12 to March 2, online and by telephone, in English and in Spanish, among a nationally representative sample of 1,117 U.S. adults who had ACA Marketplace coverage in 2025 and completed the initial KFF survey.
