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health insurance
Millions of Americans Joining the Ranks of the Uninsured Thanks to Trump-GOP Cuts in 2025
New data released by KFF underscores how "universal, seamless coverage throughout the life course remains an urgent prerogative for the nation," said one physician and advocate.
Mar 20, 2026
About 24.3 million Americans were enrolled in healthcare plans within the Affordable Care Act marketplace last year, but a survey released Thursday by KFF found that about 1 in 10 of those people had no choice but to make a difficult and risky calculation at the end of 2025 when ACA subsidies expired due to Republicans' refusal to support an extension.
According to the research, 9% of people enrolled in plans under the marketplace last year are now uninsured, having dropped their coverage—and costs were a deciding factor for the vast majority of those who left the marketplace.
The expiration of the enhanced tax credits sent premiums skyrocketing by an average of 114%, according to KFF.
The decision was unavoidable for one 54-year-old man in Texas, who told KFF simply, "Without the subsidy, I cannot afford the premium payments.”
A 56-year-old woman in Illinois said her income was too high last year to qualify for subsidies, but the increase in cost this year was "so high even for those without subsidies."
"I simply cannot afford to pay $1,200 a month for insurance," she said. "It used to be high premiums meant low deductibles and copays, but not anymore. This is ridiculous. $1,200 for a healthy person, and an $8,000 deductible. Really?”
A Florida resident named Kelly Rose told The Wall Street Journal that the $1,700 monthly premium she was quoted for an ACA plan would have been more than her mortgage. She missed the enrollment window for health coverage through her job at a bank—assuming her ACA plan would cost less—and is now uninsured and relying on a Canadian pharmacy to get her asthma medication, which would cost $800 per month without insurance in the US.
Cynthia Cox, a senior vice president at KFF, told the Journal that the survey results were “about on target” what the health policy research group had expected last year when the subsidy expiration was looming and Democrats were demanding that the GOP vote with them to extend the tax credits.
“Not only is there significant coverage loss, but there could be more to come,” Cox said.
An estimated 25 million Americans are uninsured, said Harvard Medical School professor and former Physicians for a National Health Plan president Adam Gaffney—a fact he called "abhorrent" as he suggested the new data makes the latest case for "universal, seamless coverage throughout the life course," or an expansion of the Medicare program to the entire US population.
That proposal, which has been introduced in Congress numerous times by lawmakers including Sen. Bernie Sanders (I-Vt.) and Rep. Pramila Jayapal (D-Wash.), would put the US in line with the healthcare systems of other wealthy nations, improve healthcare outcomes, and save an estimated $650 billion per year.
A poll released late last year by Data for Progress found that 65% of likely US voters supported "creating a national health insurance program, sometimes called ‘Medicare for All,’ that would cover all Americans and replace most private health insurance plans."
The fact that millions of Americans have chosen to opt out of the country's for-profit health insurance system—putting their health and finances at risk—is representative of "a profound hollowing-out and weakening of America," said writer and markets researcher Ben Hunt.
The economic justice campaign Unrig Our Economy emphasized that Republicans' cuts to healthcare last year—via the expiration of the subsidies and slashes to Medicaid—put an estimated 15 million Americans at risk of losing health coverage.
“Republicans knew that healthcare tax credits were critical to helping millions of Americans afford their health insurance, but they chose to get rid of them to fund more tax breaks for their billionaire buddies,” said Unrig Our Economy campaign director Leor Tal. “Costs are higher, millions are without insurance, and working Americans are having to make sacrifices just to afford basic healthcare—and they know that Republicans are to blame. It’s time Republicans finally started listening to their constituents and fixing the healthcare crisis they created.”
KFF's polling also found that among people who still have health insurance under the ACA, higher premiums and deductibles have left a majority concerned that they wouldn't be able to afford emergency care even with their coverage. Nearly half of respondents said they were worried that even routine medical care will be unaffordable this year with their ACA plans.
Due to Republican attacks, the cost of coverage offered by the program is now forcing 55% of people using the ACA to cut back on spending money on food, household items, and clothing in order to afford it. Forty-three percent said they are trying to find another job or extra income to afford healthcare payments, and nearly a quarter said they are skipping or delaying payments on other bills to afford their health coverage.
More than half of people polled by KFF said they blame Republicans in Congress for their rising healthcare costs.
"Americans are blaming them because it’s true," said Unrig Our Economy. "Congressional Republicans’ massive cuts to health care have put a projected 15 million Americans at risk of losing health insurance and left millions more struggling to keep up with rising costs. Republicans made these cuts all so they could give more tax breaks to billionaires and corporations."
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Insurance CEO Testimony ‘Made Case for Medicare for All Better Than Almost Anyone'
"Under Medicare for All, these insurance vultures who profit from the suffering of everyday Americans would all be out of a job—bringing down costs across the health system—which should be reason enough to support it," said one advocate.
Jan 23, 2026
If you want a compelling case for Medicare for All, just listen to the ultra-rich CEOs of the insurance companies profiting off the United States' disastrous for-profit status quo.
That was Public Citizen healthcare policy advocate Eagan Kemp's takeaway from congressional testimony delivered Thursday by the top executives of UnitedHealth Group, Cigna, Aetna owner CVS Health, Elevance, and Ascendiun, some of the largest beneficiaries of a system under which millions of Americans face massive costs, care denials, and labyrinthine administrative hurdles.
"In both of today’s House hearings, health insurance executives’ devil-may-care attitude towards Americans’ health made the case for Medicare for All better than almost anyone I have ever seen," Kemp said in a statement following the hearings held by the House Ways and Means Committee and the House Energy and Commerce Committee's healthcare panel.
"Rarely has there been a more feckless, uncaring, and unsympathetic group of paper pushers," said Kemp. "Under Medicare for All, these insurance vultures who profit from the suffering of everyday Americans would all be out of a job—bringing down costs across the health system—which should be reason enough to support it. We need Medicare for All to finally put us on par with every other comparably wealthy country by guaranteeing everyone in the U.S. can get the health care they need, throughout their lives."
The executives faced angry grilling from both Democrats and Republicans during Thursday's hearings, which came as health insurance premiums are skyrocketing due to the GOP's refusal to extend Affordable Care Act (ACA) subsidies that lapsed at the end of 2025.
"Do you understand why the American people are not a fan of UnitedHealthcare and big healthcare companies?" Rep. Nanette Barragán (D-Calif.) asked UnitedHealth Group CEO Stephen Hemsley, telling the story of a 3-year-old girl whose family was forced to take on more than $1 million in medical debt and declare bankruptcy because the insurance giant would not cover doctors' recommended treatment for a tumor in her bladder.
Rep. Greg Murphy (R-NC), who recently underwent brain surgery, told the insurance executives that he faced eight care denials for necessary medication.
"You have put profits above patients, and you have put profits above those who care for patients," said Murphy, a physician. "If it were up to me, I would throw out all for-profit systems in this country and turn everybody into nonprofit. It has gotten that bad."
"If I had my way, I'd turn all of you guys into dust," he added. "We'd start back from scratch."
The @WaysandMeansGOP held a hearing on the impact of rising health care costs on patients and families.
We have to have serious reform of health insurers, pharmacy benefit managers, and their subsidiaries to reduce the cost of healthcare. pic.twitter.com/pQEE4WgQtk
— Congressman Greg Murphy, M.D. (@RepGregMurphy) January 22, 2026
The insurance executives attempted to shift the blame for high costs and other systemic issues onto hospitals, doctors, and pharmaceutical companies, while offering Band-Aid solutions.
UnitedHealth Group's CEO pledged during his testimony to return its 2026 Affordable Care Act profits to consumers in the form of rebates.
"If you’re feeling a little misty-eyed about this sudden burst of corporate altruism, let me save you the trouble. This isn’t a moral awakening. It’s a PR maneuver and narrative control being implemented in real-time," said Wendell Potter, a former health insurance executive who now supports Medicare for All, which would virtually eliminate private insurance and provide comprehensive health coverage for everyone in the US for free at the point of service, for a lower overall cost than the for-profit status quo.
"UnitedHealth’s pledge is just a long, desperate PR pass into the end zone, praying lawmakers and reporters will focus on the gesture instead of the business model that allows them to gobble up those dollars in the first place," Potter added. "This isn’t a gift. It’s a distraction."
Kemp of Public Citizen said Thursday that “in the short term, the Senate must pass a clean three-year extension of the enhanced ACA premium tax credits to address runaway premium increases for millions of Americans."
"In the long run," he added, "we must continue building the movement that will pass Medicare for All and make it the law of the land."
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It's Obvious the US Healthcare System Isn't Working, So Why Not Try Medicare for All?
In a moment when the boundaries of what is “reasonable” or “possible” have been completely blown open, universal healthcare no longer seems so unrealistic.
Dec 18, 2025
Between the (likely) expiration of the Affordable Care Act enhanced subsidies, cuts to Medicaid and Medicare, and the decade-long efforts to undermine and dismantle the ACA, the casualties and costs of our current healthcare system continue to grow as Americans continue to wait for a better option. Nearly 45,000 Americans aged 17-65 die each year due to lack of insurance, a number that could rise to over 51,000 preventable deaths in the coming years.
Yet, the Senate has failed to pass either healthcare plan proposed to keep health insurance premiums from skyrocketing in the New Year and the Medicare for All bill introduced by Sen. Bernie Sanders (I-Vt.) and US Reps. Pramila Jayapal (D-Wash.) and Debbie Dingell (D-Mich.) in April 2025 has not advanced in Congress. Ideas like Medicare for All or universal healthcare often make eyes roll. “That’s unrealistic,” we’re told.
But is it? Universal healthcare is, after all, the reality for most other high-income countries. And yes, it might be disruptive, but Americans have lived through unprecedented changes and significant events in the past five years: the Covid-19 pandemic, the January 6 insurrection, and the rapid development of generative AI. Throughout history, major healthcare reforms have been born from disruption; Medicare is rooted in the civil rights movement, and the ACA passed in the wake of the 2008 financial crisis.
Now, as the United States prepares to celebrate its 250th anniversary, our foundational rights and institutions are being tested in ways that once would have been unthinkable. In a moment when the boundaries of what is “reasonable” or “possible” have been completely blown open, universal healthcare no longer seems so unrealistic.
Do we accept being the only high-income country where getting sick can cost you your home, your job, or your life?
We certainly can’t continue as we’ve been going. As a nurse scientist and postdoctoral fellow, I have a front-row seat to the healthcare crises we are facing: unaffordable medical bills, growing healthcare costs, long waits for specialty and even primary care appointments, and the growing burden of chronic illness and mental health crises. Employers are now shifting employees into high-deductible plans with high out-of-pocket costs. People are effectively locked into jobs they cannot leave because losing coverage, even temporarily, can be a significant financial risk—especially for those covering spouses and children.
We have extensive evidence, both internationally and within the US, showing what strategies produce better results. Any meaningful reform should include:
- Universal population coverage: Federal requirements must guarantee that every person living in the US has insurance that covers necessary healthcare services, including primary care, specialty care, mental health, reproductive health, preventive care, and hospitalizations.
- Care that is free or affordable: A largely single-payer financing model like Canada, Australia, and most high-income countries (as proposed in the “Medicare For All” bill) or a hybrid public-private system, where private insurance is still available but federally regulated to ensure cost containment, limit out-of-pocket costs, and eliminate catastrophic medical expenses, protecting families from significant medical debt.
- A focus on prevention and primary care: Meaningful investment in preventive services, primary care, and care coordination to reduce costs, prevent unnecessary emergency room visits and hospitalizations, and improve long-term health.
But people remain skeptical that we can achieve these goals in the US—largely because of public opinion and political will, both of which are significantly influenced by private health corporations, including insurance companies, large hospital systems, pharmaceutical companies, and other obscure middlemen that profit from the status quo.
For decades these corporations have spent hundreds of millions of dollars lobbying Congress and advertising to the public to protect their revenue and discourage solutions that most of us agree with and would benefit from. President Donald Trump himself criticized health insurers as “money-sucking,” calling them “BIG BAD insurance companies.” If policymakers on both sides of the aisle agree that corporate interests are getting in the way of healthcare reform, why do we continue to defer to them?
Opponents of single-payer, universal healthcare cite the costs, but the US already spends more on healthcare than other high-income countries with universal healthcare—and better health outcomes. It is expensive to maintain a broken system.
Major change is challenging but not impossible. Most Americans are dissatisfied with the costs, shortcomings, and complexities of our current healthcare system and support the idea of universal healthcare. We have the resources, expertise, and innovation to create a healthcare system that works for everyone. What we have not yet shown is the courage to do it.
As the country approaches its 250th anniversary, we should be asking what kind of nation we want to be. Do we accept being the only high-income country where getting sick can cost you your home, your job, or your life? Or do we finally build a system that treats healthcare as a public good rather than a commodity?
If the president really wants to “make America Healthy Again,” he can—through real healthcare reform. And for the rest of us, instead of just waiting to see what happens with the ACA subsidies, we can all work to build broad coalitions and support politicians who have a bold vision for healthcare and the courage to actually make a change.
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