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 healthcare 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. 吃瓜不打烊 is telling their stories.
Featured Stories
It鈥檚 2026 and You鈥檙e 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鈥檒l 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 鈥 and who will pay for it.
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More From the Project
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Affordable Care Act Insurers Want More Premium Increases as Enrollment Sags
Insurers that sell plans in Obamacare marketplaces across 16 states and the District of Columbia have asked regulators to approve a 14% median premium increase for 2027, according to a new Peterson-KFF analysis.
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Patients Face a Thicket of Red Tape Trying To Maintain Consistent Health Coverage
Many Americans are shopping around for affordable options as the cost of health insurance soars. But some who hope to keep the same doctors and medications face a thicket of red tape and disruption after they switch plans.
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Thousands of Medicare Beneficiaries Thought Their Drug Plan Was Free. Then They Lost It.
Thousands of people who had a Medicare drug plan with zero-dollar premiums last year got small premium increases this year 鈥 and didn鈥檛 know it. They were dropped from their coverage for failing to pay amounts as little as $8, and most can鈥檛 get it again until 2027.
By Susan Jaffe -
Copay Assistance Is Meant To Defray Patient Drug Costs. Some Insurers Keep It Instead.
Drugmakers provide financial assistance to help patients afford increasingly expensive medications. But some insurers do not count those payments toward a plan鈥檚 deductible or out-of-pocket maximum and make patients pay instead.
By Daniel Chang -
Affordable Healthcare Emerges as a Voter Priority in Purple Nevada
The Trump administration鈥檚 cuts to Medicaid and SNAP may complicate Republican Gov. Joe Lombardo鈥檚 reelection chances.
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Democrats Seek To Spotlight Rising Health Costs by Forcing Vote on Trump Regulation
Congressional Democrats are seeking to overturn a Trump administration rule they say will hamper Obamacare coverage. Whether they win or lose any floor vote, they鈥檒l likely use it in campaign messaging ahead of the midterms.
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They鈥檙e Uninsured After Obamacare Became Too Costly. And They鈥檙e Far From Alone.
After congressional Republicans let expanded subsidies for Affordable Care Act plans expire at the end of last year, some families have decided the price is too great of a financial burden and canceled their coverage.
By Andrew Jones -
Long-Awaited Rule Aims To Boost ACA Choices While Embracing Higher Deductibles
The Trump administration finalized a rule that embraces new types of Obamacare coverage, including 30% higher out-of-pocket costs for some plans, and a more novel approach that allows insurers to offer coverage without set networks of doctors and hospitals.
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1 in 4 Covered California Enrollees Could Get State Aid Under Newsom Proposal
California is considering expanding financial help for low-income residents struggling to pay high health insurance premiums after losing federal subsidies. But relief for state marketplace customers will be limited. Here鈥檚 who may get help and what it could mean for premiums.
By Christine Mai-Duc and Jackie Forti茅r -
Cheaper, Alternative Health Plans Are Having a Moment, but Critics Urge Caution
Congress’ decision not to extend enhanced marketplace tax credits has boosted the appeal of alternative health coverage with lower monthly premiums. Consumer advocates dismiss the plans as “junk insurance,鈥 while proponents say patients need alternatives to pricey marketplace options.
By Sarah Kwon -
Florida Delays Children鈥檚 Health Insurance Expansion as Uninsured Rate Rises
Florida鈥檚 KidCare expansion has been stuck in legal limbo since February 2024. Since then, the number of uninsured children in Florida has risen to 400,000 鈥 one of the highest state tallies.
By Daniel Chang -
They鈥檙e in Remission, but Their Medical Bills Aren鈥檛: 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鈥檛 help people who need constant care and monitoring, health policy researchers and patient advocates say.
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How To Make a High-Deductible Health Plan Work for You
Lower premiums often mean higher costs when you get sick and need care. Among the ways to plan ahead and soften the financial hit: health savings accounts, which act like a medical piggy bank.
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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鈥檛 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.
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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 鈥 and face higher repayment amounts 鈥 if they don鈥檛 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.
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Many ACA Customers Are Paying Higher Premiums. Most Blame Trump and Republicans, Poll Finds.
A KFF poll offers insights into people鈥檚 insurance coverage decisions and how those choices could play into their vote in November鈥檚 midterm elections.
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Evidence Shows ACA鈥檚 Mandated Benefits Alone Don鈥檛 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 -
鈥楰ind of Morbid鈥: 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.
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Trump Team鈥檚 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.
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Worried About Health Insurance Costs? There May Be Cheaper Options 鈥 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.
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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.
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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鈥檚 happening in the middle of ACA open enrollment.
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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 鈥 such as blaming the ACA for mergers and consolidation within the health care industry.
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Trump鈥檚 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.
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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.
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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鈥檛 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鈥檚 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.
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Shutdown Has Highlighted Washington鈥檚 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 鈥 keeping an existing provision of the Affordable Care Act alive.
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As Health Companies Get Bigger, So Do the Bills. It鈥檚 Unclear if Trump鈥檚 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 鈥 and shown some disdain for Biden officials鈥 more aggressive approach.