ObamaCare’s impact on health costs.

This Kaiser Family Foundation/New York Times survey provides an in-depth look at the experiences of Americans ages 18-64 who say they or someone in their household had problems paying medical bills in the past year. The survey explores the causes of medical bill problems and the impacts they have on individuals and their families, finances, and access to health care. To provide context, a shorter companion survey was conducted among those who do not report having medical bill problems.

Most discussions about insurance costs center around premium increases, or (less often) deductibles. Less often do we here them discussed together. Yet, the combination is a critical factor in determining how illnesses affect the financial well-being of families.

An insured family has to pay its premium regardless of whether or not any claims are made. In addition, a family has to meet its annual deductible before receiving any benefits for treatment of illnesses or injuries. That means a family has to pay the total of the premium plus the deductible before any benefits are payable.

For the first time, businesses that employ the equivalent of 50 to 99 full-time workers face a fine of $2,160 per worker if they don’t provide coverage. (An employer’s first 30 workers are excluded from the calculation.)

For an employer with the equivalent of 75 full-time workers, for example, the maximum penalty would be $97,200 for 2016.

Obama administration officials said last month that about 2.5 million new customers had bought insurance through HealthCare.gov since open enrollment began on Nov. 1. The number of new enrollees is 29% higher than last year at this time, suggesting that the threat of a larger penalty may be motivating more people to get covered.

But plenty of healthy holdouts remain, and their resistance helps explain why insurers are worried about the financial viability of the exchanges over time. People who earn too much to qualify for federal subsidies that defray the cost of coverage may be most likely to opt out.

Many insurance companies are losing money selling ObamaCare policies. Unfortunately, the White House wants to make their losses your problem. In December, Congress refused an administration request to provide insurers with $2.5 billion in bailout money to help cover their 2014 losses.

The Obama administration hasn’t given up. It has declared that this $2.5 billion in corporate welfare and potentially billions more for losses insurers have incurred in 2015 is “an obligation of the U.S. government for which full payment is required.”

A new study reveals that many ObamaCare customers pay more than 10% of their incomes toward coverage. And the share of income eaten up can be much greater for some people, particularly if they use a lot of health services under their plan.

One in 10 ObamaCare customers who earn between just two and five times the federal poverty level will have coverage costs that exceed 21% of their incomes, an analysis by the Robert Wood Johnson Foundation and the Urban Institute found.

The Urban Institute examines premiums and out-of-pocket costs, as well as total financial burdens for individuals with different characteristics enrolled in ACA-compliant nongroup coverage. Findings show that despite the financial assistance available, individuals across the income distribution who are ineligible for Medicaid can still face very high expenditures.

Even with federal government subsidies under the Affordable Care Act, a typical American buying coverage on public exchanges spends about one in 10 dollars they earn “on insurance premiums and out-of-pocket costs,”according to a new analysis.

Research from the Urban Institute shows typical single enrollees with incomes between $23,540 and $58,850 spend 10% of their incomes on premiums and out-of-pocket costs and the percentage rises if the enrollee has more medical needs.

More than 2 million existing customers with insurance under the Affordable Care Act have had coverage renewed automatically for 2016 by HealthCare.gov, after they ignored government warnings to shop around to avoid surprise spikes in prices of health plans. According to data released Tuesday, 8.2 million people already have chosen — or have been automatically assigned to — health coverage next year through the federal insurance exchange.

Americans want to know what the next U.S. president will do to lower their rising health care costs, a priority shared by Republican and Democratic voters and second only to keeping the country safe. In all, 62% of people surveyed said they would want to know about a presidential candidate’s plan for reducing health care costs.