These latest data, from Gallup’s annual Health and Healthcare poll, come as many insurers have raised premiums — as well as deductibles, copays and coinsurance — for plans under the Affordable Care Act (ACA). Meanwhile, growth in national spending on healthcare has accelerated, increasing 5.3% in 2014, according to a report from the Centers for Medicare and Medicaid Services. According to the American Academy of Actuaries, premium costs, in general, will increase for the next several years because of various market factors, and Americans should plan for such increases.

Yearly increases have been the norm, but Americans are feeling them more sharply than usual. Since 2003, the large majority of adults who pay all or some of their premiums have consistently reported that their costs have gone up. However, until now, many more said the costs went up “a little” than “a lot.” In the latest poll, the two figures are nearly tied, with 38% saying costs went up a little and 36% saying a lot. The shift comes from an eight-percentage-point increase this year in those saying their costs rose a lot, bringing it to the highest Gallup has measured since first asking the question in 2003.