Roughly one in ten Americans enrolled in the Affordable Care Act plans opted out of health insurance altogether in 2025 due to higher prices after federal subsidies expired, a new survey found. The survey, conducted by nonprofit health policy research group KFF, also found that more people reported downgrading their health insurance or facing financial stress from higher costs. Lawmakers’ decision to end the enhanced ACA subsidies in December caused health premiums to more than double for the average ACA enrollee in 2026, according to KFF. ACA enrollees now face average premium costs of $1,904, up from $888 last year, KFF previously reported. As of January, approximately 23 million Americans were enrolled in ACA plans, down from 24.2 million in 2025. Of the 1,117 US adults polled by KFF, 9% said they are now uninsured, with another 28% saying they have switched to a new plan. The poll found that over half of returning ACA marketplace enrollees blame congressional Republicans (54%) and US President Trump (53%) for higher healthcare costs. The concern over rising healthcare expenses comes as Americans struggle with the cost of living due to the ongoing war in Iran, which has driven up oil and gas prices. The record-long government shutdown last year was caused by the expiration of enhanced ACA subsidies, which Democrats sought to extend but most Republicans opposed.
"Your ZIP code should not determine your health outcomes," said Walter Panzirer, the Helmsley trustee who started the rural health program, "and yet for so many rural Americans, it does."
