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Most ACA enrollees cutting back on food, household needs to pay for health care: Poll

About 8 in 10 Affordable Care Act marketplace enrollees report higher health care costs, with 55% reducing spending on food and essentials, a KFF survey found.

  • KFF's survey of 1,117 U.S. adults with Marketplace coverage in 2025 shows about 55% plan to cut food and basic household spending, and 8 in 10 re-enrolled say costs are higher this year.
  • Failure to reach a January bipartisan compromise resulted in 23 million ACA enrollees facing higher premiums after enhanced tax credits expired Dec. 31, with Democrats in Congress pushed back by Republican leadership.
  • Many returning ACA enrollees report changing plans or tiers, with about 7 in 10 staying, 3 in 10 switching plans, 1 in 10 dropping coverage, and 2 in 10 finding alternative insurance.
  • Rising out‑of‑pocket costs are forcing behaviors such as patients rationing insulin and Priscilla Brown paying $17 monthly for a new plan while facing refill costs over $150.
  • Poll respondents largely assign blame, noting about 7 in 10 blame health insurance companies a lot, over half blame Republican lawmakers, President Donald Trump and pharmaceutical companies, and one-third blame Democrats in Congress or hospitals.
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What Americans are giving up to afford ACA health insurance, according to a new poll

A new KFF survey shows many Americans who had Affordable Care Act marketplace health insurance last year are struggling with high health costs

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KFF broke the news in on Thursday, March 19, 2026.
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