Surprise, Surprise: Millions Have Lost ACA Insurance Due To Cost Spikes

Last year, one of the longest government shutdowns in history occurred because Republicans let tax subsidies for insurance under the Affordable Care Act (ACA) expire. The shutdown ended without a deal to expand the subsidies, or even a plan to mitigate the rising costs. As a result of the GOP’s inaction, it’s projected that nearly 5 million people are now uninsured because they simply can’t afford it. 

According to the Washington Post, health policy research organization KFF projects that sign-ups for ACA insurance in 2026 will be between 16.5 million and 17.5 million, down from 22.3 million in 2025. In addition to monthly premiums going up, the average deductible has risen as well. The fall off in sign-ups comes down to two reasons: people simply not signing up for insurance after seeing the spike in monthly premiums, and people who can’t keep up with their payments and lose their coverage. 

“We know for sure that the individual market has gotten smaller and almost certainly sicker, as the people dropping coverage are more likely to be healthy,” Louise Norris, a health policy analyst for healthinsurance.org, told CBS News. 

From KFF: 

A disproportionately large share of the drop in sign-ups (27%) is among people with incomes just above the “subsidy cliff” (between 400%-500% FPL), despite this group making up just 3% of plan selections in 2025.

Premium payments from enrollees increased by an average of 58% from $113 to $178 per month. This is lower than the 114% increase KFF projected if everyone had stayed in the same plan because many people bought down to higher-deductible plans and because those just past the subsidy cliff with the steepest increases dropped ACA coverage at higher rates. Additionally, the 114% increase was among people receiving a tax credit whereas the 58% increase is among all consumers, including the most number who did not receive a tax credit in 2025.

Average ACA Marketplace deductibles increased by 37% (or $1,027 per person) to a record high of $3,786 in 2026. This is the steepest increase in deductibles ever seen in this market and largely reflects the shift from silver plans with reduced deductibles for lower-income enrollees to bronze plans with very high deductibles.

“We can’t yet quantify how much worse it will be than in previous years, but it will absolutely be worse because of the sticker shock,” Ellen Montz, a managing director with consulting firm Manatt Health, told CBS News. There’s already concern that insurance companies are going to raise prices again next year to make up for the downturn in sign-ups, which will inevitably lead to even more people going uninsured. 

I’m currently on a bronze plan, and let me tell ya, it is outright garbage. Last year, I was paying $40 a month for a silver plan that was pretty good. My prescriptions were reasonable, my visits to the doctor were mostly free, and the telehealth service was efficient. Now, I’m paying $189 a month for a bronze-tier plan that provides worse health care across the board. 

The price of my monthly steroid inhaler increased from $15 to $150. I got hit with a $202 bill for a doctor’s visit to get my prescription refiled, even though I only went because my insurer’s proprietary telehealth service didn’t have any openings for two weeks, which kind of defeats the purpose of telehealth. I know I’m probably not alone in experiencing this, as KFF’s report found that 40% of ACA enrollees signed up for bronze plans, a 10% increase from last year. 

Having this experience only made me more incredulous when President Donald Trump announced that his administration would explore “cheaper” health insurance plans that drastically increase deductibles. The proposed plan would move people to either bronze plans or even lower-tier plans that aren’t part of any established network. 

While much has been made about redistricting potentially rigging the midterms in the GOP’s favor, the Democrats would be absolutely stupid if they didn’t A) drive home all the ways Trump and the GOP have exacerbated the affordability crisis over the last two years and B) actually propose a plan that would address rising health care costs. 

If Trump really wanted to “Make America Healthy Again,” he’d make ACA coverage affordable instead of letting RFK Jr. enact policies based on whatever conspiracy theory he saw on Facebook that morning. 

SEE ALSO:

ACA Open Enrollment Reveals Increase In Monthly Premiums

6 States Expand ACA Subsidies To Offset Loss Of Federal Funds