Millions of Americans are grappling with soaring health insurance premiums as the open enrollment period for 2026 coverage begins. The expiration of expanded subsidies under the Affordable Care Act (ACA) has left many experiencing significant financial strain. Approximately 22 million people previously benefited from these subsidies, which capped premiums for benchmark plans at 8.5 percent of income. As these subsidies come to an end, many individuals are facing premium increases that have compelled them to reconsider their health coverage options.
The end of expanded subsidies, which cost the government around $35 billion annually, means that individuals will revert to the lower subsidy levels that were in place in 2021. Many are reporting drastic increases in their monthly premiums. For instance, Jeff Rowan, a retiree from Colorado, saw his monthly premium for a health plan on the state exchange skyrocket from $350 to approximately $900. Faced with this surge, he opted for a plan through his pension, which still represents a 100 percent increase.
Rowan articulated the fear driving his decision-making: “The fear of something unexpected happening and my moderate savings being wiped out is forcing me to pay the piper. It’s a completely fear-based decision.” This sentiment echoes widely among Americans navigating the current insurance landscape.
In Wisconsin, small-business owner Galen Perkins recounted a past experience of forgoing insurance and suffering the consequences. Now, with his ACA premium increasing by 25 percent, he has resolved to pay the higher rate. Perkins anticipates that many will cut back on discretionary spending, saying, “We’re just going to buy food, pay rent, pay health insurance, and that’s it.” He expressed concern that these changes could have broader economic implications.
Elected officials are hearing similar stories from constituents. Rep. Seth Magaziner (D-RI) reported that residents are experiencing “staggering” premium increases. One constituent, a retired marketing executive, shared that her monthly payment could rise from $600 to $2,120, marking a 250 percent increase. Another, who runs a small business, is facing an 89 percent hike in her premiums. “Americans cannot afford these price increases,” Magaziner stated, emphasizing the potential impact on household budgets nationwide.
In Colorado, staff for Sen. Michael Bennet (D-CO) revealed they received over 3,200 messages in one month regarding health care costs. Bennet remarked, “Working families are already struggling to get by as the costs of childcare, rent, and groceries continue to skyrocket.” He urged for the extension of ACA premium tax credits to alleviate some of the financial burdens.
The political landscape surrounding health care is complex. Former President Donald Trump expressed that he would only support a plan that sends money directly back to citizens, suggesting that individuals should negotiate their own insurance. “THE PEOPLE WILL BE ALLOWED TO NEGOTIATE AND BUY THEIR OWN, MUCH BETTER, INSURANCE,” he stated in a recent post.
Republican lawmakers are reportedly considering alternative solutions, such as flexible savings accounts to enable direct negotiations with health care providers. Critics argue that this approach may not effectively address the underlying issues, as insurers typically have more negotiating power with hospitals.
The expiration of the ACA subsidies threatens to disrupt the health care landscape significantly. Dr. Vikas Saini, president of the Lown Institute, highlighted the potential consequences of a shrinking risk pool, where healthier individuals opt out of coverage. This shift could increase costs for remaining policyholders, as the average insured individual may present higher health risks.
Many individuals are witnessing these effects firsthand. Taylor M., who works in a health care provider in New York, mentioned that his employer-provided insurance is increasing by 30 percent, placing additional financial pressure on families. Another individual, Sam from Portland, Oregon, found that the lowest-cost ACA bronze plan would cost him around $420 monthly but would not cover essential medications. As a result, he has shifted to his wife’s private insurance, adding $500 to their monthly expenses.
The current climate has prompted uncertainty, with some families worrying about the impact of potential policy changes on their dependents. Options being discussed include enrolling in “short-term” insurance plans, which have been criticized for their limited coverage.
As Americans brace themselves for the implications of these changes, the outlook for health insurance remains precarious. Rising premiums could force many to forgo coverage altogether, further complicating an already challenging health care system. The forthcoming months will be crucial in determining how individuals and families navigate this evolving landscape.
