How Americans covered through ACA exchanges are navigating the spike in premiums

Geoff Bennett:

We are just weeks away from some 20 million Americans seeing a major spike in their health care premiums. That's unless Congress works to extend the subsidies under the Affordable Care Act.

Lawmakers expanded and boosted those tax credits during the pandemic, making coverage more affordable for millions of families. But if the subsidies expire at the end of the year, premiums would double for the average enrollee and some people could see their monthly costs rise by more than $1,000.

William Brangham joins us now with more — William.

William Brangham:

Geoff, that's right.

This battle over extending subsidies was at the very heart of the recent government shutdown. But Democrats were not successful in securing any deal. And now both parties remain deadlocked over this issue. The Congressional Budget Office estimates that more than two million will not be able to pay these higher premiums or other costs, and thus will drop their insurance.

Here's what we heard from some people who are afraid of just that.

Crystal Akers, Kentucky:

My name is Crystal Akers, and I live in Bowling Green, Kentucky.

I got a notice October 1 that my premium, as of November 1, would be going up over $500.

ReShonda Young, Iowa:

My name is ReShonda Young, and I live in Waterloo, Iowa.

My premiums with the premium tax credit are $94 per month. And without that credit, they go to $592 a month.

Tenika Mason, Tennessee:

My name is Tenika Mason, and I live in Dayton, Tennessee.

My husband logged on to the marketplace the first day it was available and saw that our premiums are going to increase by $1,100. And that is actually devastating to us. The increase is about 225 percent from what we were paying previously.

Melissa Ruff, Florida:

I am Melissa Ruff. I'm in Jacksonville, Florida.

If nothing happens with the subsidies being extended by December 31, my premiums will go from $238 a month to $1,308 a month for my insurance, which is not even top-of-the-line insurance.

Crystal Akers:

The subsidies through the marketplace since the ACA went into effect have allowed me to have insurance as a single parent. Without that, it's unmanageable for my budget.

ReShonda Young:

I had gotten a breast cancer diagnosis a little over a year ago. And so having a good, reliable plan was incredibly helpful, because, even with a plan, you have got to pay your deductibles. I still had to pay thousands of dollars out of pocket, but at least my monthly premiums were affordable.

Tenika Mason:

Our daughter is a brain cancer survivor, and we have to go with the insurer that covers the specialists that she needs. My husband and myself also have health issues that require multiple visits with specialists throughout the year. So not having insurance is not an option for us. It would ruin us financially.

Melissa Ruff:

I found out in 2022 that I had heart disease. So it allowed me to have a cardiac cath at very minimal cost, and stress-testing and echocardiograms and mammograms and GYN and everything else and all of my medications. So, now, without it, without any health insurance, that's what I'm facing.

Crystal Akers:

I think the ACA was a step in the right direction. My biggest problem with it is how unstable it's gotten. So it becomes impossible, I think, for the middle class to get ahead.

Melissa Ruff:

I would not have been able to get health care back prior to the ACA because of preexisting conditions. So now the preexisting condition thing with Obamacare, is that going to be cut too?

ReShonda Young:

The frustrating thing for me is that you have members of Congress who have an incredible health insurance plan. They don't understand what it's like to have to decide between health insurance and decreasing my food budget for the month.

Crystal Akers:

I'm still in the process of figuring out what I'm going to do next. As far as I'm concerned right now, I don't have insurance. I turned off my payment for November, and I have just got to figure out my options.

Melissa Ruff:

I have chosen to go without insurance in 2026. I'm not going to be able to afford it.

ReShonda Young:

It was such a surprise for me to get a cancer diagnosis, and so just knowing that life happens, and not having it is also not an option.