Earlier this month, as I waited to pick up a prescription at my local CVS, I watched a man leave without his elderly father’s medication. The pharmacist had tried several tricks to lower the cost. It wasn’t enough. When the man heard the bottom line, he stuffed his hands in his pockets and, after a long, awkward silence, walked away.
That’s become a depressingly common scene. Americans are struggling to pay for their medicines, living in fear of health emergencies and skipping out on basics like meals in order to cover their insurance premiums. Increasingly, they are going without insurance altogether.
That strain is showing up in a slew of recent surveys that point like a neon arrow to a growing problem for the Trump administration: Health care has become unaffordable for most Americans. A bigger problem? Most of Trump’s policies announced so far will make the situation worse.
The latest polling data underscoring the challenges Americans face comes from health policy researchers at KFF and offers the first glimpse at the fallout from the recent loss of Affordable Care Act subsidies. Without those tax credits, premiums for marketplace plans have soared, leading to monthly bills that are double their previous cost or even more.
The KFF survey, conducted in late February and March, follows up on a group of ACA customers previously interviewed in November amid a fierce congressional battle over extending the Biden-era subsidies. These had significantly lowered the cost of higher-quality insurance and brought millions of new enrollees into the marketplace, including many who work for small businesses or are self-employed.
The survey’s findings are “not pretty,” the president and chief executive officer of KFF, Drew Altman, told reporters on a call to discuss the data. Some 80% of people enrolled in marketplace plans say costs like monthly premiums and deductibles have gone up, and it’s straining their budgets.
“More than half (tell) us they can’t afford food or other basic needs because of their new, higher health care costs,” Altman said.
One in 10 people have dropped coverage altogether, and one in six people who kept it said they weren’t sure they could afford their plan for the entire year. Meanwhile, about a quarter of enrollees have transitioned to cheaper, high-deductible plans that could be financially disastrous if they experience a health emergency.
The situation could worsen still. In the past, subsidies automatically renewed from year to year, but a little-noticed provision in the One Big Beautiful Bill Act will end that practice in 2028., notes Adrianna McIntyre, a health-policy expert at the Harvard T.H. Chan School of Public Health. Given many people allow their plans to roll over, the concern is they will find their premium in 2028 has skyrocketed — and if they don’t notice during the grace period to change it, they could end up dropping coverage altogether
It’s not just people relying on ACA plans and public insurance who are struggling with affordability. Most Americans under 65 get insurance through their employers, and they, too, are feeling the strain. Four in 10 people with private insurance say their health-care costs rose in the past year, according to a survey recently released by the Employee Benefit Research Institute. A third of the privately insured said they had trouble paying other bills, and a quarter reported putting less money in their retirement funds because of health-care costs.
A recent Gallup poll underscored the terrible trade-offs many are making to access care. The insured and uninsured alike are skipping meals, borrowing money, stretching out their medicines and cutting back on other essentials to pay for doctors’ visits or prescriptions.
That poll was released this month, but it was conducted last summer. Given the worsening situation in 2026, it’s not hard to imagine next year’s data will look bleaker.
So far at least, Trump’s policies do little to improve the situation for most Americans — and if anything will make it worse. The president’s signature OBBB introduced new work requirements for Medicaid that are expected to leave millions more uninsured when they kick in next year.
The rising cost of health care might have predated Trump’s second term, but his policies are exacerbating it. The consequences aren’t subtle, either. They’re being felt every day by ordinary Americans forced to consider what they are willing to give up just to stay healthy.