Can the U.S. Make Health Care More Affordable Without Sacrificing Quality?

by Anamika October 6, 2026

Picture opening your insurance renewal and finding the monthly bill has nearly doubled. For millions of Americans this year, that was real life.

What Changed in 2026

Enhanced Affordable Care Act tax credits expired at the end of 2025. On average, the more than 20 million subsidized enrollees are seeing premiums rise by 114% in 2026, according to KFF. That works out to roughly $888 a year in 2025 versus $1,904 this year.

The Latest Updates

Congress hasn’t fixed it. In December, the Senate rejected both a Democratic plan to extend the subsidies for three years and a Republican alternative built around health savings accounts.

The strain is showing. A March 2026 KFF survey found 80% of returning marketplace enrollees saw higher costs, and more than half cut back on food or household spending to cover care. Deductibles hurt too, since the average bronze plan deductible topped $7,000 nationally.

Why It Matters

When premiums jump, healthier and younger people tend to drop coverage first. Urban Institute and Commonwealth Fund researchers projected about 4.8 million people could go uninsured in 2026. A sicker pool pushes prices up again, and hospitals absorb more unpaid care.

Can Quality Survive Lower Costs?

Here’s the honest answer: it depends on how costs come down. Cutting what patients pay through subsidies is different from cutting what care actually costs, like prices, billing waste, and administrative overhead. The first protects access but not the budget. Savings accounts offer flexibility but may leave sicker patients exposed. Most analysts agree that real affordability needs both: help for families now and tougher scrutiny of prices later.