Health Insurance Costs Force Many to Skip Medicine, Cut Basic Needs

A new survey reveals that 4 out of 5 Americans with Affordable Care Act insurance face higher healthcare costs this year, with many cutting back on food and necessities to afford medical care. The increased expenses stem from the expiration of enhanced tax credits that previously helped offset premium costs.

Priscilla Brown faces an impossible choice each day: take her full diabetes medication or have enough money for gas to get to work. The 48-year-old Orlando truck dispatcher sometimes reduces her insulin to just half or one-third of what doctors prescribed, trying to make it last longer.

“Sometimes I don’t even take my medicine,” Brown explained. “It’s so much with insurance, it’s crazy.”

Brown’s struggle reflects a nationwide crisis revealed in new research from KFF, a healthcare nonprofit. Their survey found that roughly 4 out of 5 Americans who renewed their Affordable Care Act insurance report facing steeper healthcare expenses this year, with approximately half describing their costs as significantly higher.

The primary driver behind these climbing expenses was the December 31st end of expanded tax credits that had helped reduce premiums for most marketplace participants.

The financial strain is forcing difficult decisions across the country. Among the 1,117 surveyed Americans who held ACA marketplace insurance in 2025 – including those who dropped or switched coverage – approximately 55% plan to reduce spending on groceries and essential household items to manage their medical expenses.

Congressional Democrats had pushed to maintain the pandemic-era subsidies last year but encountered resistance from Republican leaders. By January, efforts toward a bipartisan solution collapsed, leaving roughly 23 million ACA participants without assistance as they confronted increased premiums or difficult choices to cancel or downgrade their plans.

The February and March survey, which reconnected with participants from a previous year’s study to track their current insurance challenges, reveals how the ongoing congressional stalemate continues affecting ordinary Americans while many federal legislators have shifted focus to other issues.

Brown’s situation illustrates the dramatic change. Last year, she paid nothing for her health insurance premiums. Her current plan costs $17 monthly and includes a higher deductible.

This week, Brown discovered her medication refill would exceed $150 and “almost passed out.” She put only half a tank of gas in her car, saving money for her prescriptions.

The survey shows widespread anxiety about unexpected medical bills. Roughly three-quarters of people who had ACA coverage last year express significant concern about affording emergency treatment or hospital stays, while about half worry about routine doctor visits or prescription medications.

Most previous enrollees – about 70% – maintained ACA health insurance, though this includes roughly 30% who switched plans within the marketplace. Meanwhile, approximately 20% became eligible for employer-provided coverage, Medicare, Medicaid, or bought insurance outside the ACA marketplace, which typically offers less comprehensive benefits.

About 10% of last year’s participants dropped coverage entirely and now lack insurance, according to the poll.

Eric LeVasseur, a 63-year-old Seal Beach, California software developer, joined that uninsured group. When he discovered his mid-level silver plan would nearly triple to $1,200 monthly, “it was not something my budget could absorb,” he said.

Approximately 70% of returning ACA enrollees experiencing higher costs heavily blame health insurance companies, while just over half place significant blame on Republican lawmakers, President Donald Trump, and pharmaceutical companies. About one-third heavily blamed Congressional Democrats or hospitals, while roughly 10% placed this level of responsibility on doctors or employers.

Survey participants who identified with a political party and experienced cost increases overwhelmingly blamed opposing party lawmakers.

James Mako, a Boca Raton, Florida engineer and political independent, holds the Republican Party responsible. His $500 monthly premiums were set to double for his silver-level ACA plan this year, forcing him to downgrade to a bronze-level plan with higher out-of-pocket costs.

Mako remains skeptical of Republican proposals to address the problem, such as directing funds into health savings accounts.

“I think they’re just sales gimmicks,” he stated. “The subsidies should be back.”

The KFF survey was conducted February 12 through March 2, 2026, among 1,117 U.S. adults who held Marketplace insurance in 2025, using samples from two probability-based panels. All participants had taken part in the 2025 KFF Marketplace Survey and were recontacted for this follow-up study. The margin of sampling error for the complete sample is plus or minus 3.8 percentage points.