When Health Insurance Costs More Than the Mortgage
As health care costs skyrocket and federal lawmakers pull back help on insurance premiums, more middle-income families are facing tough choices on health care.
Priced Out
America’s Health Insurance Crisis
Skyrocketing health care costs and insurance premiums combined with congressional inaction have forced a perilous decision upon many people: Pay higher prices for health insurance or go uncovered. KFF Health News is telling their stories.
Featured Stories
It’s 2026 and You’re Uninsured. Now What?
Many Americans are expected to lose ACA or Medicaid coverage in coming months and years as a result of the One Big Beautiful Bill Act and the expiration of enhanced pandemic-era subsidies that helped people afford Obamacare plans. Doctors and researchers say there are still ways to find affordable care.
On the Hook for Uninsured Residents, Counties Now Wonder How They’ll Pay
Millions of people gained health coverage under the Affordable Care Act, reducing pressure on counties in states that fund care for the uninsured. With federal policies expected to reverse that trend, county officials wonder how they will fill the gap — and who will pay for it.
Share Your Story
Are you struggling to afford your health insurance? Have you decided to forgo coverage?
Click below to contact KFF Health News and share your story.
More From the Project
-
They’re in Remission, but Their Medical Bills Aren’t: Cancer Survivors Navigate Soaring Costs
The costs of posttreatment care are forcing cancer survivors to make tough choices. GOP proposals to bring down health insurance costs won’t help people who need constant care and monitoring, health policy researchers and patient advocates say.
-
Farm Bureau Health Plans Beat the ACA on Prices With an Age-Old Tactic: Rejecting Sick People
Fourteen states now allow health coverage through state farm bureaus. Though they generally share many features of Affordable Care Act marketplace plans, they aren’t insurance. Neither are they typically subject to federal or state health insurance requirements, and the benefits may be less generous or predictable than those of Obamacare plans.
-
Tax Time Brings Surprises for Some Who Receive ACA Subsidies
Some people find they owe money back for subsidies if their income changed from what they estimated. In 2026, more people may find themselves in this situation — and face higher repayment amounts — if they don’t carefully track their income.
By Julie Appleby and Andrew Jones -
Rising Health Costs Push Some Middle-Aged Adults To Skip the Doc Until Medicare
Adults ages 50 through 64 faced some of the steepest increases in out-of-pocket costs for Obamacare plans after a set of federal subsidies expired at the end of December. Some say they are putting off care or considering dropping health insurance coverage until Medicare picks up the bill.
-
Many ACA Customers Are Paying Higher Premiums. Most Blame Trump and Republicans, Poll Finds.
A KFF poll offers insights into people’s insurance coverage decisions and how those choices could play into their vote in November’s midterm elections.
-
Evidence Shows ACA’s Mandated Benefits Alone Don’t Drive Up Costs. The Debate Continues.
The Affordable Care Act put in place a package of benefits that health insurance plans must cover. Critics contend this mandate has jacked up premiums. Evidence supporting that claim is mixed.
By Julie Appleby and Sarah Boden -
‘Kind of Morbid’: Health Premiums Threaten Their Nest Egg. A Terminal Diagnosis May Spare It.
Chaz and Jean Franklin were facing a sevenfold increase in their health premium payments with the expiration of enhanced federal subsidies for Affordable Care Act plans at the end of 2025. Then Jean received a crushing diagnosis that will claim her life but save the couple money.
-
Trump Team’s Planned ACA Rule Offers Its Answer to Rising Premium Costs: Catastrophic Coverage
Sweeping changes to the Affordable Care Act marketplace next year have been proposed by the Trump administration that focus on making more insurance plans available with higher annual out-of-pocket costs but lower premiums.
-
Obamacare Sign-Ups Drop, but the Extent Won’t Be Clear for Months
Experts say Affordable Care Act sign-up data won’t be clear until people who were enrolled have paid — or haven’t paid — their new, often much higher, premiums.
-
Worried About Health Insurance Costs? There May Be Cheaper Options — But With Trade-Offs
As the clock ticks down on the 2026 Obamacare open enrollment season, frustrated consumers may have to make sacrifices on coverage to get a price they can stomach. But cheaper alternatives come with risks.
-
One Big Beautiful Bill Act Complicates State Health Care Affordability Efforts
The federal budget bill President Donald Trump signed into law in July is creating uncertainty for states trying to rein in health care spending. In California, a lawsuit by the hospital industry challenging state spending caps cites the law, which will slash Medicaid spending, as one of many financial pressures.
-
Sticker Shock: Obamacare Customers Confront Premium Spikes as Congress Dithers
With subsidies that give consumers extra help paying their health insurance premiums set to expire, lawmakers are again debating the Affordable Care Act. The difference this time: It’s happening in the middle of ACA open enrollment.
-
Health Care Consolidation and Rising Costs Happen, but Obamacare Is Not the Key Culprit
The debate over expiring Affordable Care Act tax credits has given Republicans room to resurface old criticisms — such as blaming the ACA for mergers and consolidation within the health care industry.
-
Trump’s Idea for Health Accounts Has Been Tried. Millions of Patients Have Ended Up in Debt.
Republican calls to give Americans cash instead of health insurance subsidies double down on a decades-old strategy of moving people into high-deductible plans with health savings accounts.
-
Out-of-Pocket Pain From High-Deductible Plans Means Skimping on Care
High-deductible health insurance plans are increasingly common, and many more enrollees will likely need to choose such plans for the coming year. For those with chronic conditions like diabetes, the gamble can mean compromised care and long-term consequences.
-
Health Savings Accounts, Backed by GOP, Cover Fancy Saunas but Not Insurance Premiums
Health savings accounts can be used to cover medical expenses, tax-free. But while wealthier Americans are using them to pay for gym equipment, cedar ice baths, and hemlock saunas, poorer Americans can’t use them to pay their skyrocketing health insurance premiums.
By Amanda Seitz -
After Shutdown, Federal Employees Face New Uncertainty: Affording Health Insurance
Average premium payments in the federal government’s insurance program for its employees are set to jump more than 12% next year, on top of a 13.5% hike in 2025. The two-year increase is higher than many private employers and their workers are experiencing.
-
Shutdown Has Highlighted Washington’s Retreat From Big Ideas on Health Care
As voters feel financial pressure from runaway health care costs and crave innovations that would provide relief, the standoff in Congress has been firmly rooted in the status quo — keeping an existing provision of the Affordable Care Act alive.
-
As Health Companies Get Bigger, So Do the Bills. It’s Unclear if Trump’s Team Will Intervene.
As health systems, doctor groups, and insurers merge into ever-bigger giants, patient care gets more expensive. Yet the Trump administration has sent mixed signals about its willingness to intervene — and shown some disdain for Biden officials’ more aggressive approach.
-
Farmers, Barbers, and GOP Lawmakers Grapple With the Fate of ACA Tax Credits
Small-business owners and their employees, who make up nearly half of the Obamacare marketplace, are worried about their health care and their livelihoods as insurance prices surge. Republicans, who have long opposed Obamacare, are at odds over how to respond to upset from one of their party’s most loyal constituencies.
By Amanda Seitz -
Congressional Stalemate Creates Chaos for Obamacare Shoppers
This year, Affordable Care Act marketplace consumers will need to be more informed than ever to navigate their health coverage choices.
-
A Ticking Clock: How States Are Preparing for a Last-Minute Obamacare Deal
Even if Congress strikes a deal soon to extend more generous Affordable Care Act subsidies, the prices and types of ACA plans available could change dramatically. Unprecedented uncertainty and upheaval could cloud this year’s open enrollment season, which begins in most states on Saturday.
By Amanda Seitz and Julie Appleby -
GOP Talking Point Holds ACA Is Haunted by ‘Phantom’ Enrollees, but the Devil’s in the Data
Enhanced Affordable Care Act marketplace subsidies have emerged as a flash point in the congressional standoff over the federal government shutdown. Republicans point to what they characterize as increasing amounts of fraud as a reason to hold up the subsidies. But there are two sides to the story.
-
Why Democrats Are Casting the Government Shutdown as a Health Care Showdown
Democrats are pressuring Republicans to extend billions of dollars in federal tax credits that have dramatically lowered premiums and contributed to record-low rates of uninsured Americans. It’s a chance to talk about a winning issue — and maybe regain support from working-class voters.
By Amanda Seitz -
Team Trump’s Answer to Ballooning Obamacare Premiums: Less Generous Coverage
Tens of millions of people face sticker shock enrolling in Affordable Care Act insurance for 2026. To save money, the Trump administration wants them to consider less generous coverage.
-
Projected Surge in Uninsured Will Strain Local Health Systems
In South Texas’ Rio Grande Valley, many people go without health insurance, and the health system struggles as a result. Similar communities dot the nation, and more could face such difficulties under President Donald Trump’s tax-and-spending law.
By Sam Whitehead and Renuka Rayasam -
Insurers and Customers Brace for Double Whammy to Obamacare Premiums
Consumers face both rising premiums and falling subsidies next year in Obamacare plans, with insurers seeking increases to cover not only rising costs but also some policy changes advanced by President Donald Trump and the GOP.
-
In a First, Trump and GOP-Led Congress Prepare To Swell Ranks of US Uninsured
Fewer Americans will likely have health insurance, compromising their physical and financial health, as the Trump administration and GOP-controlled Congress weigh major changes to the Affordable Care Act and Medicaid. “The effects could be catastrophic,” one policy analyst predicts.
By Renuka Rayasam and Sam Whitehead -
The Price You Pay for an Obamacare Plan Could Surge Next Year
An estimated 4 million Americans will lose health insurance over the next decade if Congress doesn’t extend enhanced subsidies for Affordable Care Act marketplace coverage, which expire at the end of the year. Florida and Texas would see the biggest losses, in part because they have not expanded Medicaid eligibility.
By Daniel Chang