A Weaker ACA Will Cost All Americans

As we observe the evolution of insurance coverage in just the past year or so, it appears the United States is trending in the wrong direction. According to the Commonwealth Fund, among working-age adults the uninsured rate rose from 8.9% in 2024 to 11.2% in 2026. This difference translates to 4.6 million more Americans being uninsured in 2026 than in 2024. Furthermore, 46% of working-age adults were either uninsured, experienced a coverage gap or were underinsured in 2026.

Between 2010 and 2025, the rate of people who were without health insurance fell from 16% to 8%, largely owing to coverage expansions under the Affordable Care Act. But as the latest Commonwealth Fund survey on health insurance points out, rising numbers of un- and underinsured are a re-emerging issue. The percentage of working-age adults without coverage rose to 11.2% in 2026. Healthcare policy analysts attribute this to expiring enhanced subsidies in the Affordable Care Act market and the high cost of (alternative options for) insurance.