Cost Concerns and Coverage Changes: A Follow-Up Survey of ACA Marketplace Enrollees Authors: Lunna Lopes, Isabelle Valdes, Grace Sparks, Mardet Mulugeta, and Ashley Kirzinger Published: Mar 19, 2026

https://www.kff.org/public-opinion/a-follow-up-survey-of-aca-marketplace-enrollees/?utm_campaign=KFF-This-Week&utm_medium=email&_hsenc=p2ANqtz-8uo0n1udHS61Su2P16nZVTVI4ZBkt0xOSr1ZCsP282wiEjjaCVtEHJZL00FHMVS7RMOkXQ0i5UPwuOn3cPROlnoG7h_A&_hsmi=409789188&utm_content=409789188&utm_source=hs_email At the end of 2025, despite a government shutdown over the policy, the enhanced premium tax credits expired, decreasing financial assistance for subsidized Marketplace enrollees and contributing to significant increases in the Affordable Care Act (ACA) Marketplace costs for most enrollees overall. Amid the debates leading up to the expiration, KFF conducted a probability-based survey of 1,350 adults covered by ACA Marketplace plans in late 2025 to better understand their worries about potential cost increases for their health coverage. Now—without the enhanced tax credits in place—KFF re-interviewed 1,117 individuals (more than 80% of the original sample) to learn how they are navigating these changes to the ACA Marketplace. https://kffhealthnews.org/news/article/kff-poll-aca-obamacare-higher-premiums-blame-trump-gop/?utm_campaign=KFF-This-Week&utm_medium=email&_hsenc=p2ANqtz-9grj-S7WFOYgTQwgJY540C371l7Eq8YKIdOveuEGUUaDLEscfYA6nd5MaxwNMvvrPWNn1RpCVFyf5vuTduuIH2DGPiKA&_hsmi=409789188&utm_content=409789188&utm_source=hs_email A new KFF follow-up survey of Marketplace enrollees that KFF surveyed in late 2025 finds that half (51%) of returning enrollees say their health care costs are “a lot higher” this year compared to last year, before the enhanced premium tax credits expired, including four in 10 who specifically say their premiums are “a lot higher.” In all, a large majority (80%) of these enrollees say their health care costs, which can include premiums, deductibles, co-pays, or coinsurance, are higher.