ACA Costs Soar: Families Dropping Coverage

The expiration of enhanced Affordable Care Act (ACA) tax credits at the end of 2025 has led to millions of Americans dropping their health insurance. The Tobiassen family in western North Carolina canceled their ACA coverage when their monthly premiums increased from $130 to over $550. This decision came after years of rising healthcare costs despite relying on ACA subsidies since 2014.

North Carolina experienced the most significant decline in ACA enrollment for 2026, with a 22% decrease, amounting to over 213,000 fewer people covered. Nationally, enrollment could drop from over 22 million to an estimated 16.5 million in 2026.

Experts note that the departure of healthier individuals from the ACA risk pool could lead to future premium increases for those who remain. Many individuals are now expressing concerns about the financial burden of potential illnesses or injuries without coverage, relying on savings or credit cards for medical emergencies.

This situation impacts various groups, including self-employed individuals, part-time workers, and those with chronic illnesses who do not qualify for Medicaid but cannot afford marketplace plans. The rising costs have made even the cheapest ACA options, like bronze plans, unaffordable without subsidies.