1 out of every 4 ACA enrollees would probably give up health insurance if premiums doubled

A recent survey by KFF reveals that 25% of Americans enrolled in the Affordable Care Act (ACA) might forgo health coverage if their monthly premiums double next year. The findings were released as the ACA open enrollment period is underway, with many Americans facing unexpected increases in their 2026 premiums.

Currently, enhanced premium tax credits that help roughly 22 million Americans afford monthly premiums are set to expire at year-end, leaving uncertainty over whether Congress will extend them.

The poll, conducted in early to mid-November with 1,350 adults aged 18-64, examined Americans' plans for ACA coverage. Ashley Kirzinger, KFFs survey methodology director, explained that the goal was to hear directly from those affected about their coverage decisions for 2026.

Results show that about one-third of ACA enrollees would actively seek cheaper plans if premiums doubled or if they currently pay nothing but would face a $50 monthly charge. Notably, one in four said they would likely abandon insurance under these conditions, highlighting a potentially significant rise in the uninsured population.

"The ACA has lowered the uninsurance rate over the past decade," Kirzinger noted. "These increases could have serious consequences as more people may be forced to go without coverage, not by choice but due to cost."

Impact on Families

Jon, a 38-year-old from Florida, described the strain on his family, which requires a robust plan due to his wifes autoimmune condition. Their current $2,000 monthly premium for four people is projected to rise to $2,500 in 2026. Jon shared that although insurance is essential, rising costs force difficult trade-offs between monthly expenses and healthcare coverage.

Similarly, Venus, 27, from Kentucky, highlighted the financial pressure of single-income households covering multiple chronic conditions. Her familys premium, currently $200 each, is expected to rise by $90, prompting concern about potentially losing coverage if costs doubled.

Financial Strain

The survey also found that 58% of enrollees could not handle a $300 yearly premium increase without major financial disruption, while 20% could not absorb a $1,000 increase. If overall healthcare expenses climb by $1,000 next year, 67% said they would cut household spending, and 41% would likely delay other bills.

More than half of ACA participants expect their premiums to rise "significantly" next year, with an additional 25% anticipating a moderate increase. These projections underscore the growing challenge many Americans face in maintaining health insurance coverage amid rising costs.

Author: Aiden Foster