Priscilla Brown, a 48-year-old truck dispatcher from Orlando, Florida, finds herself caught in a difficult dilemma between managing her Type 2 diabetes and affording essential living expenses. Rising healthcare costs have forced her to sometimes limit her insulin dosage or skip it altogether. “Sometimes I don’t even take my medicine,” she said, expressing the strain that high prescription prices and insurance complexities have placed on her budget.
Recent data from a KFF survey reveals that an overwhelming majority of Americans who re-enrolled in Affordable Care Act (ACA) marketplace coverage have experienced increased healthcare costs this year. Approximately 80% of those surveyed reported higher expenses, with nearly half indicating their costs rose “a lot.” This spike is attributed largely to the expiration of enhanced tax credits at the end of 2022, which had previously alleviated premiums for many enrollees.
The financial burden is impacting daily life significantly for many. Out of 1,117 respondents who had ACA marketplace coverage in 2025, around 55% reported they planned to cope with rising healthcare costs by cutting back on food and other basic household expenses.
Despite efforts by Democratic lawmakers last year to advocate for the extension of COVID-era subsidies, opposition from Republican leadership halted progress. As a result, approximately 23 million ACA enrollees are left without financial relief, facing the difficult choice of higher premiums or the necessity to downgrade or disenroll from their plans.
Brown’s personal experiences highlight the anxiety felt among many ACA enrollees regarding unexpected medical costs. In the past year, her health insurance premiums were nonexistent, but now her new plan costs $17 a month and comes with a higher deductible. Recently, she was alarmed to discover that a refill of her medication would cost over $150, compelling her to compromise on fuel for her vehicle to afford the medication.
The poll indicates that concerns surrounding medical costs are widespread. Nearly 75% of respondents expressed being “very” or “somewhat” worried about affording emergency services or hospitalizations, and half feel similarly about routine medical visits or prescriptions.
While around 70% of last year’s enrollees maintained their ACA health insurance, many switched plans within the marketplace, with a significant portion eligible for other types of coverage through employers, Medicare, or Medicaid. Alarmingly, about 10% of last year’s enrollees dropped their coverage entirely, leaving them uninsured. Eric LeVasseur, a software developer from Seal Beach, California, experienced this firsthand; when his silver-level plan’s premium nearly tripled to $1,200 per month, he found it unsustainable and had to seek lower-tier coverage.
The blame for rising healthcare costs appears to be widely directed. Nearly 70% of returning ACA enrollees attributed their financial woes primarily to health insurance companies, while over half held Republican lawmakers accountable, alongside pharmaceutical companies. Political affiliation seems to influence blame; respondents often pointed fingers at lawmakers from the opposing party.
James Mako, an engineer from Boca Raton, Florida, who identifies as politically independent, expressed skepticism towards proposed Republican solutions like health savings accounts. He downgraded his plan due to a projected doubling of his premiums but insists that reinstating the subsidies should be the priority.
Conducted between February and March, the KFF poll sheds light on the ongoing struggles faced by many Americans in the healthcare landscape. The findings reveal not just the financial challenges posed by rising healthcare costs but also the broader implications on the daily lives of those trying to make sense of an intricate and often burdensome system.
