A new KFF poll lands with a jolt: one in four Americans on Affordable Care Act plans says they may drop cover next year if premiums double.
Open enrolment started last month, and people already felt the pinch when they saw notices outlining 2026 pricing.
The shock comes as enhanced premium tax credits, which help roughly 22 mn Americans, run out at year-end. Congress hasn’t said whether it will extend them, and maybe can’t agree until late in the game.
Researchers surveyed a nationally representative group of 1,350 adults aged 18 to 64 during early to mid-November.
The goal, according to KFF’s Ashley Kirzinger, was to hear directly from marketplace enrollees who must decide whether 2026 coverage still fits their finances or just breaks them.
One in three respondents said they’d shop for a cheaper plan if premiums doubled or if they currently pay nothing and would face a $50 monthly bill. The numbers swing fast, and the trend line isn’t pretty.
The part that caught analysts’ attention came next. One in four said they’d likely go uninsured altogether under the same scenario. That’s a sharp turn for a programme credited with lowering the US uninsurance rate for more than a decade.
Kirzinger says the point isn’t that people suddenly stopped valuing cover. They’re boxed in by cost, plain and simple.
Stories behind the data make the situation more vivid. Jon, 38, from Florida, needs strong cover for his family because his wife has an autoimmune disorder. Their premium sits at $2,000 a month for four people and will hit $2,500 next year.
He fears the financial cliff that a single medical event could trigger. So the family may pick a cheaper plan, though it raises copays for GP visits and emergency care. He phrased it bluntly: they’re being forced to judge the value of their own health.
The financial strain runs wider. About 58% of enrollees say they can’t absorb even a $300 annual increase without disrupting their budget.
Another 20% says a $1,000 rise wrecks household finances. If total costs climb by $1,000 next year – premiums, deductibles, all of it – two thirds of respondents say they’ll cut daily household needs, and 41% expect to skip or delay bills.
Expectations for 2026 aren’t comforting either. Roughly 54% anticipate their premiums will rise far more than usual, and another quarter expects somewhat higher increases.
Venus, 27, from Kentucky, says the monthly bill for her and her husband already strains their single-income household.
Both have chronic illnesses, and while their high-deductible plan keeps premiums lower at around $200 a month, those out-of-pocket costs loom large.
Their premium is set to jump another $90 soon, which eats into their already thin budget. If payments doubled, she says they’d have to consider going uninsured – a thought she can’t quite process, given the price of insulin.
According to Beinsure analysts, these stories suggest rising premiums and the potential loss of tax credits could push the ACA into one of its roughest affordability cycles since launch.
The marketplace still offers options, sure, but for millions of families the economics keep tightening faster than they can adjust.
