MW Soaring healthcare costs are forcing people to make troubling trade-offs, like skipping meals - and the situation is about to get worse
Andrew Keshner
Here's one woman's plan: 'Shopping for cheaper groceries, not buying clothes, avoiding getting sick, not being as social'
Two new surveys paint a similar picture of the toll of Americans' healthcare costs.
Stretching out prescriptions, skipping meals and borrowing money.
These are some of the sacrifices Americans are making to cope with rising healthcare costs, according to two surveys released within days of each other.
More than half of people (55%) purchasing health coverage this year through the Affordable Care Act say they have reduced other household spending, or plan to cut back, to pay for increasingly pricey premiums, according to a KFF survey released Thursday.
A 63-year-old woman told KFF her strategies for dealing with higher premiums included: "Shopping for cheaper groceries, not buying clothes, avoiding getting sick, not being as social." A 39-year-old man said his plan was to "pare back expenses as much as possible." About 3 in 10 people said higher ACA premiums made it harder for them to cover their utilities, their rent or mortgage, or their gas or other transportation costs.
The KFF survey looked at those who still had ACA coverage after a tax subsidy expired at the end of 2025. A recent Gallup poll on the impact of rising healthcare costs overall painted the same picture of policyholders under pressure.
Three in 10 people with health insurance said they had made at least one financial sacrifice in the last 12 months to pay for health expenses, according to Gallup. Prolonging prescriptions, borrowing money, driving less and skipping meals were the most cited methods. People without insurance cited those trade-offs roughly twice as much.
That's not the only way healthcare expenses interfered with financial well-being. People said they had delayed vacations, medical treatment, job changes and home purchases due to healthcare costs, Gallup found.
Those who postponed milestone events included people living in six-figure households. Almost half of people making between $120,000 and $180,000 said they had delayed important life moves, while 34% of those making between $180,000 and $240,000 said they did the same.
The surveys add to a mounting body of evidence that healthcare and health-insurance costs are ratcheting up pressure on both consumers and businesses. The toll is getting noticed by central bankers and on Wall Street, and even by employers deciding what kind of pay raise they can give their staff.
On Wednesday, Federal Reserve Chair Jerome Powell said Americans are feeling "squeezed," when answering a question on inflation and consumer psychology.
"There are areas where prices are still going up, like insurance," Powell said. "Various different kinds of insurance are getting more and more expensive. And that's just catching up, really, from inflationary pressures that take a while to get to the price."
Indeed, car-insurance premiums and homeowners insurance aren't offering much relief to policyholders, either.
Meanwhile, consumers are already reeling from other climbing prices. The war in Iran has sparked a global oil supply crisis leading to higher gasoline costs. U.S. drivers were paying an average of $3.88 for a gallon of gas on Thursday, according to AAA. That's a 78-cent increase on a price that carries a lot of weight in consumers' minds.
The chances are that more people will be forced into hard decisions about their health-insurance coverage in the months to come. That's true for self-employed workers, entrepreneurs and early retirees buying plans through Affordable Care Act exchanges. After the enhanced premium tax credit expired, this year's ACA premiums increased by over 20%, according to the Urban Institute.
In January, the Centers for Medicare & Medicaid Services said 23 million people had signed up for 2026 coverage on Healthcare.gov and state-run exchanges. That was 1.2 million fewer people than last year.
More people could drop their coverage in April and May once they see the impact of higher costs, health-industry experts say. What becomes more clear in the coming two months are "effectuated enrollment" numbers, which are the numbers of people who actually pay their premiums, said Ellen Montz, a managing director with Manatt Health.
For returning policyholders, there's a three-month grace period to pay the first month's premium, Montz noted. At least some new customers signed up hoping enhanced subsidies would be extended at some point this year, and now "many folks just won't be able to make the numbers work with their budgets," she said.
"We won't know official numbers until summer, but I expect future surveys will reflect continued enrollment declines and stark budgeting tradeoffs," Montz said.
According to the KFF survey, 16% of people with ACA coverage said they were not confident they could afford their plan this year.
Shares of health insurer Centene $(CNC)$ fell earlier this month after the company said it was possible that 40% of its ACA policyholders could drop coverage by the end of 2026.
-Andrew Keshner
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March 20, 2026 08:00 ET (12:00 GMT)
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