More than 1 in 4 Americans say they or a family member went without needed health care in the past two years because they felt they could not afford it, according to a new poll.

The survey from Monmouth University released Monday finds that 27 percent of adults say they or a member of their household have avoided necessary medical care in the past two years because of cost. That figure is down slightly from 2017, when 31 percent said they had skipped care.

The era of annual eye-popping Obamacare rate hikes appears to be over.

Premium increases in the law’s marketplaces are on track to be relatively modest for the second straight year, according to the first batch of 2020 rates proposed by insurers. The rate filings are an early indication that this year’s small rate hikes weren’t a fluke and that other Trump administration policies — including support for a lawsuit that could torch the Affordable Care Act — have proven less disruptive than some experts feared.

Nine years after Democrats passed the Affordable Care Act and more than a year after Republicans failed in their effort to repeal it, health care promises once again to be a major issue in the 2020 elections.

Drug costs are rising, as are insurance premiums. Rural hospitals are closing. Even as an estimated 20 million people have gained coverage under the ACA, widely known as Obamacare, nearly 30 million people remain uninsured. Surveys consistently find that Americans see the health-care system as broken.

Americans cited health care as the top issue for the federal government to address, ahead of the economy, immigration, national security and other issues, Wall Street Journal/NBC News polling found this month.

The financial burden of health care was of particular concern for American families, according to a new Gallup poll released last week, trumping worries linked to wages, college expenses, housing and taxes.