ACA Open Enrollment Begins: Can Americans Afford Rising Health Insurance Costs?

Open enrollment under the Affordable Care Act (ACA) started on November 1, and premiums are expected to rise by 13%, according to research from health-research nonprofit KFF. How do Americans feel about the ACA, and how will rising healthcare costs influence their coverage decisions?

Increased Rates of Uninsured Adults: Contributor Joshua Cohen at Forbes (Center bias) wrote that the rate of working-age adults without health insurance rose from 8.9% in 2024 to 11.3% in 2026, when many Biden-era ACA subsidies expired, and it will likely continue to rise in 2027. On the other hand, Cohen noted that uninsured rates fell from 16% to 8% from 2010 to 2025, which he argued was "largely owing to coverage expansions" under the ACA. Cohen argued that this new growth in uninsured adults is a sign that things are "moving in the wrong direction," especially considering that people opting out of insurance due to the high cost are likely to "lead to delayed care and rising medical debt if and when patients do seek treatment." Ultimately, Cohen questioned "the sustainability of a system that costs Americans much more out-of-pocket every year, has rising un- and underinsured rates and yields comparatively subpar health outcomes."

Why Everyone Should Care: Opinion columnist Lisa Jarvis, writing for Bloomberg (Center), argued that "a weaker ACA will cost all Americans," both socially and financially. Jarvis argued that "when more people go uninsured…hospitals see a rise in uncompensated care," the cost of which is then passed on to privately insured patients in the form of higher prices for care. Additionally, Jarvis wrote that plan options under the ACA marketplace have dwindled, leaving many Americans with fewer, and worse, options to choose from. Jarvis ultimately argued that because high rates of uninsured adults affect everyone, that even Americans who do not rely on the ACA for health coverage should still have "a vested interest in a healthier healthcare ecosystem."

Better Options at the State Level: Guest contributor Tony Lo Sasso wrote an opinion for Wall Street Journal (Opinion) (Lean Right) in favor of Georgia's approach to healthcare subsidies, which pays the subsidiary directly to health insurance enrollees rather than pays they "invisibly" to the health insurance companies. Rather than arguing against government-subsidized healthcare entirely, Sasso claimed that these kinds of fixed, direct-to-consumer subsidies motivate enrollees to shop for better deals on health insurance and in turn force companies to remain competitive, "just like a real market." Sasso's piece called for other states to "follow Georgia's lead" and design their own ACA reforms to benefit Americans.

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