ACA Subsidy End Drives Up Costs, Coverage Losses

The expiration of enhanced federal subsidies for Affordable Care Act marketplace health insurance at the end of 2025 has driven up costs for millions of enrollees, leaving about one in 10 without coverage this year and forcing many others into financial tradeoffs to stay insured.

A survey of 1,117 U.S. adults who had ACA marketplace plans in 2025, conducted by the nonpartisan health policy research group KFF from February 12 to March 2, 2026, found that 80 percent of returning enrollees reported higher health care expenses, including premiums, deductibles and copays. For more than half, or 51 percent, these costs were substantially greater than the previous year. The subsidies, which benefited around 22 million people and reduced monthly premiums for over 90 percent of enrollees, more than doubled average premium payments for those who kept the same plans.

Lunna Lopes, a senior survey manager at KFF, said returning enrollees are really struggling with costs. The lapse has prompted varied responses among the 69 percent who reenrolled for 2026. Nearly three in 10 switched to different plans, often downgrading to bronze-tier options with lower upfront premiums but higher...