Health is a human right—and a foundation for everything else. This feed explores the challenges and innovations in healthcare, mental health, and public wellness. From access and equity to breakthroughs and advocacy, discover how people and policies are working to ensure everyone has the chance to live a healthy, thriving life.

Health

A tiny unpaid balance triggered a massive financial fallout—highlighting gaps in healthcare protections.

Protecting Americans From Losing Health Coverage

She Owed Her Insurer a Nickel, So It Canceled Her Coverage

Rising premiums and expiring subsidies are leaving millions of Americans struggling to afford health coverage—and shaping how they vote.

Restoring Affordable Health Insurance for American Families

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<a href="https://kffhealthnews.org/news/author/julie-appleby/">Julie Appleby</a> | <a href="https://kffhealthnews.org">KFF Health News</a> Mar. 19, 2026
		
Most people who get their health coverage through the Affordable Care Act say they face sharply higher costs, with many worried they will have to pare back other expenses to cover them, according to a <a href="https://www.kff.org/public-opinion/a-follow-up-survey-of-aca-marketplace-enrollees/">poll released Thursday</a>. Some are uncertain whether they will be able to continue paying their premiums all year.<div>	</div>Still, 69% of those enrolled last year signed up again this year, often for less generous coverage. About 9% said they had to forgo insurance, according to the survey by KFF, a health information nonprofit that includes KFF Health News.The KFF poll revisited the people who responded to <a href="https://www.kff.org/public-opinion/2025-kff-marketplace-enrollees-survey/">a November KFF survey</a> of Affordable Care Act enrollees during open enrollment for ACA plans.Steve Davis, a 64-year-old retired car salesman in Rogersville, Tennessee, who participated in both polls, said he was looking at an annual premium of about $14,000 to renew his ACA coverage this year. He didn’t qualify for enough of a tax credit to defray the cost, he said, after Congress gridlocked on an extension of more-generous subsidies put in place under President Joe Biden.But things worked out for Davis. He landed a job at a convenience store that came with insurance, with his share costing about $100 more a month than the $300 he paid for an ACA plan last year, before the enhanced tax credits expired.“As it happened, the Lord provided and my insurance kicked in through my employer,” he told KFF Health News.In the November survey, many respondents were not sure what they would do for their health insurance in the coming year.Some were waiting to see whether Congress would extend the enhanced premium subsidies, which had helped many people get lower-cost — or even zero-cost — health premiums.Congress’ inaction left some consumers in a bind.Now, the new poll found, affordability issues are hitting home as the midterm election approaches. And that might play a role in competitive districts, creating headwinds for Republicans.<h2>Midterm Signals</h2>Across all respondents who were registered to vote, the poll found more than half place “a lot” of blame for rising costs on Republicans in Congress (54%), with a similar share putting the same level of blame on President Donald Trump (53%). A smaller group placed a lot of the blame on congressional Democrats (34%). Among independents, a group expected to be a key factor in many districts, the percentages putting a lot of the blame on the GOP (56%) and Trump (58%) were higher.Among Republicans, 60% placed a lot of the blame on Democrats in Congress.“Those who have marketplace coverage, who remained on it, they’re really struggling with health care costs,” said Lunna Lopes, senior survey manager for KFF.While more than half (55%) of returning ACA enrollees said they will have to pare back on other household expenses to cover health care costs, about 17% said they might not be able to continue paying insurance premiums throughout the year.Overall, 80% of those who reenrolled for 2026 said their premiums, deductibles, or other costs are higher this year than last, with 51% saying they are “a lot higher.”About three-quarters of ACA enrollees in the survey who were registered voters said the cost of health care will have an impact on their decision to vote — and on which party’s candidate they support.Democrats were more than twice as likely as Republicans to say those costs will have a major impact on their decision.“Democrats seem particularly more energized by health care costs than their Republican counterparts,” Lopes said.<h2>Enrollment Tally Down</h2>Data released Jan. 28 by federal officials showed that about 23 million people enrolled in Obamacare plans across the federal healthcare.gov marketplace and those run by states, about 1.2 million fewer than in 2025.But it isn’t yet known how many are paying their monthly premiums on time, and many analysts expect overall enrollment numbers to fall as that data becomes available in the coming months.For most people, having to pay more for premiums this year was mainly due to the expiration of the enhanced tax cuts, pollsters noted. Because the subsidies that remain are less generous, households have to pay more of their income toward coverage. Congressional inaction also meant the restoration of an income cap for subsidies at four times the poverty level, or $62,600 for an individual, sticking people like Davis with higher bills.Not everyone saw increases.Matthew Rutledge, a 32-year-old substitute teacher in Apple Valley, California, who participated in both KFF polls, said he qualified as low-income and his subsidies fully offset his monthly premium payment, just as they did last year. He does have copayments when he sees a doctor or accesses other medical care, but he told KFF Health News that “as long as the premium doesn’t go up, I’m fine with it.”Rising premiums are fueled by a variety of factors, including hospital costs, doctors’ services, and the prices of drugs.To lower premiums, insurers offer plans with higher deductibles or copayments. In the ACA, plans with lower premiums but higher deductibles are called “catastrophic” or “bronze” plans. “Silver” plans generally balance premiums and out-of-pocket spending, while the highest-premium plans with lower deductibles are “gold” or “platinum.”About 28% of those who stayed in the ACA marketplaces switched plans, the pollsters noted.One 56-year-old Texas man told pollsters that his family’s income exceeded the cap for subsidies, so they switched down from a gold plan to a bronze. “Even doing that, our premiums are three times what they were in 2025, with lower plan features and a higher deductible,” he said, according to a KFF poll news release.For some, reenrolling was not a viable option.In addition to the 9% who said they are now uninsured, about 5% said they switched to some type of non-ACA coverage.Some people, like Davis, landed job-based coverage, while others found they qualified for Medicaid, the joint state-federal program for low-income residents.Such churn in and out of ACA coverage is not unusual, Lopes noted. “People get a job. They get married. They age into Medicare,” the program for older or disabled people, she said.The poll highlighted that many people dropping coverage were younger, between 18 and 29. About 14% of people in that range now say they are uninsured. That’s not surprising, given that younger people tend to use health coverage less. ACA insurers said one reason they raised premiums this year was because they expected more young or healthy people to drop out, leaving them with a higher share of older, more costly enrollees. Among those 50 or older, the poll found that only 7% are now uninsured.GOP critics of the now-expired enhanced subsidies say they were always meant to be temporary. Extending them would have cost about $350 billion from 2026 to 2035, <a href="https://www.cbo.gov/publication/61734">according to the Congressional Budget Office</a>.But not extending them means more people will become uninsured. The CBO said the extension would have meant 3.8 million more people having insurance coverage in 2035.KFF pollsters, in February and early March, surveyed 1,117 U.S. adults, more than 80% of the ACA enrollees originally polled in November, online and by telephone. The margin of error is plus or minus four percentage points for the full sample.Are you struggling to afford your health insurance? Have you decided to forgo coverage? <a href="https://kffhealthnews.org/help-us-report-on-rising-insurance-costs/">Click here</a> to contact KFF Health News and share your story.<a href="https://kffhealthnews.org/about-us">KFF Health News</a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about <a href="https://www.kff.org/about-us">KFF</a>.<a href="https://kffhealthnews.org/morning-briefing/">Subscribe</a> to KFF Health News' free Morning Briefing.This <a target="_blank" href="https://kffhealthnews.org/news/article/kff-poll-aca-obamacare-higher-premiums-blame-trump-gop/">article</a> first appeared on <a target="_blank" href="https://kffhealthnews.org">KFF Health News</a> and is republished here under a <a target="_blank" href="https://creativecommons.org/licenses/by-nd/4.0/">Creative Commons Attribution-NoDerivatives 4.0 International License</a>.<img src="https://kffhealthnews.org/wp-content/uploads/sites/2/2023/04/kffhealthnews-icon.png?w=150" style="width:1em;height:1em;margin-left:10px;">
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Many ACA Customers Are Paying Higher Premiums. Most Blame Trump and Republicans, Poll Finds

One year after confirmation, the Health and Human Services secretary faces scrutiny over vaccine policy changes and funding reversals that critics say contradict his Senate assurances.

Holding RFK Jr. Accountable and Protecting Vaccine Access

RFK Jr. Made Promises in Order To Become Health Secretary. He’s Broken Many of Them.

For millions of expectant parents, Medicaid provides a critical lifeline to prenatal and postpartum care when insurance is out of reach.

Protect Medicaid Coverage for Pregnant People and New Parents

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	<a href="https://kffhealthnews.org/news/author/blake-farmer-nashville-public-radio/">Blake Farmer, Nashville Public Radio</a> and <a href="https://kffhealthnews.org/news/author/cara-anthony/">Cara Anthony</a> and <a href="https://kffhealthnews.org/news/author/emily-siner-nashville-public-radio/">Emily Siner, Nashville Public Radio</a> | <a href="https://kffhealthnews.org">
KFF Health News</a> 
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	When she noticed an unusual craving for hot dogs, Matte’a Brooks suspected her body was telling her something, so she decided to take a pregnancy test. She took two just to be sure. Both were positive.“I was definitely scared,” said Brooks, 23, who was uninsured. “I was like, OK … I’m pregnant, so where do I go from here?”Until then she hadn’t thought much about health care, but that changed when she found out that her daughter was on the way.Brooks got that news last winter. The mix of joy, anxiety, and excitement she felt mirrors what many new parents feel at this time of year. Many Americans find out in January or February that they’re expecting, because in the U.S., August has consistently high birth rates.A growing body of research shows that prenatal care can make a huge difference to the long-term health of both the parent and baby. This is part of why <a href="https://www.kff.org/medicaid/5-key-facts-about-medicaid-and-pregnancy/">every state</a> offers health coverage to pregnant women who meet income requirements and might otherwise go uninsured.As a result, Medicaid pays for more than 40% of births in the U.S. and an even higher percentage in rural areas, according to KFF. But Medicaid also comes with limitations, and providers may restrict how many Medicaid patients they take, since the payments are <a href="https://healthcostinstitute.org/all-hcci-reports/average-payments-for-childbirth-among-the-commercially-insured-and-fee-for-service-medicaid/">substantially lower</a> than other insurers’.Here are three things to know about signing up for Medicaid when pregnant.<h2>1. Pregnancy Makes You a Priority</h2>To sign up for government health care, you have to meet a number of requirements that vary widely by state. Most importantly, your income has to be below a certain threshold. In several states, most adults cannot qualify, regardless of income, if they’re not disabled or the parent of a child.But the math is different for pregnancy. In Tennessee, for example, the eligibility cutoff in pregnancy is <a href="https://www.tn.gov/content/dam/tn/tenncare/documents/eligibilityrefguide.pdf">more than double</a> the income threshold for some other residents. So if you didn’t qualify for Medicaid previously and are now pregnant, it’s worth double-checking your state’s requirements.<h2>2. Getting Covered Can Be Surprisingly Easy</h2>To apply, you’ll likely <a href="https://www.usa.gov/medicaid-chip-insurance#:~:text=Your%20name%20and%20date%20of,insurance%20plan%20you%20currently%20have">need to provide</a> proof of income, your Social Security number, and proof of residency. Brooks, an Illinois resident, told HealthQ that she found the sign-up process surprisingly easy. She learned about Medicaid from the provider at her initial prenatal visit.“They asked if I had insurance. I didn’t know anything at the time,” she said. The nonprofit clinic gave her some phone numbers for the state Medicaid agency. She called and went to an in-person appointment to complete her application. She walked out of the office with coverage. In <a href="https://www.kff.org/state-health-policy-data/state-indicator/presumptive-eligibility/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D">28 states</a>, pregnancy results in “presumptive eligibility,” which provides immediate coverage — even without confirmation of the pregnancy — while the application goes through the approval process.<h2>3. Coverage Can Go Beyond Standard Medical Care</h2>Medicaid provides all prenatal care at no out-of-pocket cost and usually a <a href="https://www.kff.org/medicaid/medicaid-postpartum-coverage-extension-tracker/">full year</a> of postpartum care. That’s what happened to Brooks: Her appointments, medications, and delivery were free.States cover dental, vision, and mental health care to varying degrees. Ashley Farrell, who lost her job when she was pregnant and applied to Medicaid in Georgia, said she received “rewards for going to your appointments,” including <a href="https://www.pshpgeorgia.com/value-added-services.html">grocery cards and a breast pump</a>. Benefits vary by state.<h2>People and Policy</h2>Some maternal health advocates <a href="https://www.mmhla.org/articles/the-one-big-beautiful-bill-act-obbba-and-its-impact-on-maternal-mental-health">are worried</a> about how Medicaid cuts in the One Big Beautiful Bill Act will affect pregnancy coverage. Though it’s unclear when or how, states might scale back eligibility or offerings for expectant mothers.Katherine Ruppelt at Nashville Public Radio contributed to this report.HealthQ is a health series from reporters Cara Anthony and Blake Farmer — approachable guides to an unapproachable health care system. It’s a collaboration between Nashville Public Radio and KFF Health News.<a href="https://kffhealthnews.org/about-us">KFF Health News</a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about <a href="https://www.kff.org/about-us">KFF</a>.<a href="https://kffhealthnews.org/morning-briefing/">Subscribe</a> to KFF Health News' free Morning Briefing.This <a target="_blank" href="https://kffhealthnews.org/news/article/healthq-pregnancy-pregnant-uninsured-medicaid-prenatal-postpartum/">article</a> first appeared on <a target="_blank" href="https://kffhealthnews.org">KFF Health News</a> and is republished here under a <a target="_blank" href="https://creativecommons.org/licenses/by-nd/4.0/">Creative Commons Attribution-NoDerivatives 4.0 International License</a>.<img src="https://kffhealthnews.org/wp-content/uploads/sites/2/2023/04/kffhealthnews-icon.png?w=150" style="width:1em;height:1em;margin-left:10px;">
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If You’re Pregnant and Uninsured, Medicaid Might Be Your Answer

As ACA subsidies expire, families across the country are being forced to gamble with their health just to stay afloat.

Restoring ACA Subsidies