Poll: Most on ACA Exchange Can’t Afford Even Modest Increases in Health Costs

A new survey of Americans currently enrolled in the Affordable Care Act (ACA) marketplace finds that most would not be able to afford even modest increases in costs.

The poll comes as tax credits intended to help some on the program afford their health expenses are just weeks away from expiring.

According to KFF, which administered the poll, if no action is taken to remedy the situation, premium payments will increase, on average, by 114 percent for 22 million Americans currently receiving those tax credits. Collectively, those individuals and families will likely see costs increase by $23 billion over the next year alone.

The poll asked respondents, composed solely of people currently on the ACA marketplace, whether they could afford price increases to their health care spending. Nearly 6 in 10 (58 percent) said that they wouldn’t be able to afford even a $300 annual increase to their health care costs. Another 20 percent said they couldn’t afford an increase of $1,000 annually, with another 9 percent stating that an increase of $2,000 would be too much for them.

Respondents were also asked what options they might take if their premiums double as a result of the credits expiring. Fifty-two percent said they would consider simply going without health insurance altogether, with 25 percent of respondents saying it was “very likely” and 27 percent saying it was “somewhat likely.”

Unsurprisingly, a majority of respondents in the poll, 84 percent, said they want the credits to be renewed. Respondents were also clear on who they would blame if the credits aren’t renewed by the end of the year: Republicans in Congress (35 percent) and President Donald Trump (41 percent). Less than a quarter of respondents (23 percent) said they would blame Democrats.

And while Trump has promised to fix the crisis, most ACA marketplace members don’t place much trust in him to do so. Asked how much confidence they have in Trump to address rising health care costs, only 34 percent said they had “a lot” or “some” confidence in him, while 65 percent said they had “not too much” or no confidence in him at all.

If prices do increase for marketplace enrollees, 54 percent said it would have a major impact on how they would vote, while another 17 percent said it would have a minor impact — a staggering figure just 11 months out from the 2026 midterm elections, which will likely center on the broader issue of affordability.

Meanwhile, Trump has attempted to shift the blame onto Democrats for rising health care costs, despite the fact that his “One Big Beautiful Bill” Act — a budget bill that included a plethora of spending and tax policies — neglected to renew these credits.

“When you see the increases in Obamacare, it never worked. It never will work,” Trump said, adding that “we can do something better” that will cost “less money” and provide “better health care.”

Notably, another plan could insure more people for less cost: Medicare for All. In a report authored by Sen. Bernie Sanders (I-Vermont) in October, the senator recognized that Trump and Republicans were capitalizing off of premium hikes due to the expiration of tax credits.

“In my view, we have to do what every other major country on earth has done, and guarantee health care as a human right through a Medicare for All, single-payer system,” Sanders wrote. “But in the midst of all of this, Trump and his Republican colleagues are doing exactly the opposite. They are making a horrific situation even worse by pushing our health care system to the verge of collapse.”

On Thursday, Senate Democrats announced they would force a vote next week on extending the ACA tax credits. The bill would enact a “clean” three-year extension of the credits, meaning the legislation will not include any attachments, Senate Minority Leader Chuck Schumer (D-New York) said.

Added Schumer:

Republicans have one week to decide where they stand: Vote for this bill and bring health care costs down, or block this bill and send premiums skyrocketing. That’s what’s at stake when we vote next week. It’s going to be one of the most important votes we take.

The up-or-down vote is part of a handshake agreement, reached between Democrats and Republicans, that led to the end of a lengthy government shutdown last month.

Schumer indicated that every Democratic senator is supportive of the bill. It’s possible that it could also attract support from a few Republicans. However, a Senate filibuster from other Republicans is predicted to block its passage.