Name: The Quiet Fallout From Higher ACA Premiums
Uploaded: 2026-02-26T04:58:41.000Z
Duration: 5 min 13 s
Description: Thousands of YouTube videos with English-Chinese subtitles! Now you can learn to understand native speakers, expand your vocabulary, and improve your pronunciation...

Participle clauses

More than a million fewer people have signed up for ACA Marketplace health coverage so far in 2026, compared with last year.

That's the first time enrollment appears to have fallen since 2020.

Basic passive voice

I spoke with several people who were forced to make a choice between a more expensive plan and taking a risk.

And it really only comes down to one of three choices.

First, they could drop their health insurance entirely.

Robin and her husband, who run a small business together in Ohio, chose this route.

Dropping our health insurance was a significant decision for us.

So I'm enrolled because of how expensive it was this year.

My son is currently enrolled in the ACA market, and

I, myself, and my spouse have opted not to enroll.

Robin's family was paying about $750 per month in 2025 for coverage to cover herself, her husband, and

However, to keep that same plan in 2026, their premium would have risen to nearly $1,000 a month.

They were already considering switching plans because she felt her existing coverage didn't provide access to many doctors.

What we decided was to say, we'll take what we were putting toward the premium last year and just set it aside each month so that if medical issues arise, we can pull from that pot.

Now, keep in mind, the average premium payments for subsidized enrollees who keep the same plan have more than doubled, from an average of $888 in 2025 and to $1904 in 2026.

And considering nearly half of Americans said they live paycheck to paycheck in 2024, odds are they can't afford this expense.

We had to kind of make a calculation because we can't just, like, pull 300 extra dollars out of our butt.

We made the calculation of, like, well, we can't be paying this much every month, but

hopefully we won't have to, like, go to the hospital.

This brings us to the next option Americans have, which is to downgrade their plan.

Last year, Kate and her husband were enrolled in a mid tier plan known as the Silver Plan on the Marketplace, and

Their overall deductible was $0 from medical care and $1,500 for prescriptions.

However, after the enhanced subsidies expired, they downgraded to a Brown's plan, which provides less coverage.

Their monthly premium rose to about $157.

The trade off was a much higher deductible of roughly $15,000.

I just worry because nobody knows what's going to happen.

Nobody knows if they're going to get in, like a car accident or, you know, something comes out of left field so that if there is an emergency, you're not going into debt for the rest of your life.

Finally, the last option is to keep their existing coverage and pay more.

I spoke with Nancy Lender in Georgia, who declined to appear on camera, but

she told me that she decided she absolutely needed insurance, even though her Premium tripled from $162 in 2025 to about $483 this year.

Nancy, who's 47 years old, has regular visits with a roster of doctors due to a host of medical issues that include complications from a brain tumor.

Nancy and her husband realize that they're going to have to budget more just because they have to stomach much higher costs for health care premiums.

now pick fast food rather than a sit down restaurant.

They won't be taking a vacation this year.

Nancy told me she really misses vacations.

There really aren't that many options other than the ACA for people who do not qualify for insurance outside of employment.

Kate told me the cost of health insurance has also made her rethink something bigger, whether she can afford to keep doing the work that she loves.

Is there going to be a point in time where, like, I need to just stop doing this and I have to get a different job?

My husband is kind of like potentially going to go that route?

We're not exactly sure yet because also the job market is a total nightmare right now.

So it almost even feels like that's a risk too financially is like switching to something else.

Because if you're gonna try to get a better job where you're making good money and, like, you have all the benefits and stuff, like, you probably have to get trained, you know, to do something like that and who knows how long that training will be and what does it cost and all this stuff.

I feel like it's really easy to get trapped.

Interestingly, red states are the ones most affected by this issue.

More than 3 in 4 ACA Marketplace enrollees in 2025 live in states won by President Trump in the last election.

In those states, 80% of all premium tax credits nationwide, about $115 billion went to enrollees in those Trump won states.

Some pundits feel the issue could swing the outcome of upcoming midterm elections.

Two out of three Americans say they're worried about the ability to pay for health care more than any other household necessity.

This puts health costs squarely in focus at a time when pollsters say affordability will be a central theme of the election cycle.