When Jessica Chamberlain went to sign up for health insurance coverage under the Affordable Care Act (ACA) for 2026, she not prepared for the sticker shock.
Last year, Chamberlain was paying $59.67 in monthly premiums. This year, she would be paying nearly $100.
The 43-year-old mother of two from Illinois said she was floored to see her monthly premiums were nearly doubling.
1.4 million fewer people enrolled in ACA plans as premiums spike, tax credits expire
“I can’t afford that as a single mom with two kids,” she told ABC News.
After carefully weighing her options, Chamberlain decide to forego health insurance and is currently uninsured.
“What do I sacrifice [to pay for health insurance]? I’m diabetic,” she said. “What do I have to sacrifice to keep my medications and my health afloat?
Chamberlain is not alone. Nearly one in 10 people enrolled in the ACA Marketplace last year dropped their coverage in 2026, according to a new KFF survey published Thursday.
Stefani Reynolds/Bloomberg via Getty Images, FILE – PHOTO: In this Nov. 1, 2025, file photo, the healthcare.gov website is shown on a laptop in Norfolk, Virginia.
The findings come amid rising health care costs and the end of the enhanced premium tax credits. The tax credits helped lower the cost of monthly premiums for about 22 million Americans covered under the ACA and expired at the end of 2025, with no plans by Congress to extend them.
The survey built upon a previous KFF poll conducted in 2025 among Marketplace enrollees. Surveyors re-interviewed more than 1,100 adults between Feb. 2 and March 2, 2026.
Of the respondents, 69% said they re-enrolled in Marketplace coverage with 39% selecting the same plan and 29% switching plans.
More than half, or 51%, of returning ACA enrollees said their health care costs are “a lot higher” this year compared to last year. Of this group, four in 10 specifically said their premiums are “a lot higher.” Additionally, 80% said all health care costs — including premiums, deductibles, co-pays or coinsurance — are higher.
Meanwhile, 9% of Marketplace enrollees dropped their ACA coverage and are currently uninsured.
When asked why they decided to drop or change their coverage, most respondents said costs were the driving factor.
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One of the respondents, Holly Weir, a 26-year-old from Ohio, told ABC News she was paying $30 in monthly premiums last year under a plan run by UnitedHealthcare. This year, her plan went to $177 in monthly premiums.
“I didn’t do anything to pick a new health care plan. I got the bill in the mail and I was like, ‘[Expletive]!'” Weir said. “I didn’t pay too much attention until I got the bill the next month and I was like ‘Oh my God, this isn’t from me going to see a medical provider.'”
Weir decided to cancel her insurance and has applied for Medicaid coverage. She is currently waiting to see if she will be approved.
Weir said she is a thyroid cancer survivor, and she has to see an oncologist every two months or so, in addition to taking regular medication.
“Once that runs out, I’ll get a lot more scared,” she said. “Of course, I’m not going to be stupid and leave it so long. If it does come to it, I’ll pay [for the insurance]. The idea that I would have to spend that each month is frustrating. I’m already not doing amazingly financially.”
The survey found that even those who re-enrolled in the ACA Marketplace may need to rework their household budgets.
Stefani Reynolds/Bloomberg via Getty Images, FILE – PHOTO: In this Nov. 1, 2025, file photo, the healthcare.gov website is shown on a laptop in Norfolk, Virginia.
More than half, or 55%, said they need to cut spending on food or other basic household expenses to afford their health care costs.
Among those with chronic health conditions, 62% of those who reenrolled in the ACA Marketplace said they will be cutting back on food and other basics.
The survey found that 22% of respondents did not re-enroll in the ACA Marketplace and got coverage through an employer, Medicare, Medicaid or another health plan outside the Marketplace.
Chamberlain, who also responded to the survey, said her kids qualify to be on state-run Medicaid. However, she said she doesn’t qualify because she makes too much in her current role working in probation.
She is hoping she can find another insurance plan to help cover health care costs.
“This is destroying people who have pre-existing conditions,” she said. “It is affecting people, especially single moms. We’re just trying to live.”
