Concerns Rise Over Health Insurance Costs
In December, Cassidy Hooter faced a troubling surprise: her health insurance premiums were set to increase significantly this year. Living in Shreveport, Louisiana, and currently in the last trimester of a high-risk pregnancy, she knew she needed immediate care. Unfortunately, with the expiration of federal subsidies, families like hers can no longer afford the Affordable Care Act (ACA) plans, which translates to thousands of extra dollars in out-of-pocket expenses.
“We really considered that it might be cheaper to give birth at home,” Hooter, 24, reflected. “This kind of debt is overwhelming.” In a tough spot, she and her husband ultimately decided to drop their insurance altogether.
A local medical center stepped in to provide three months of financial assistance to help them until her due date in February, but after that, she’d be on the hook for subsequent medical costs. They’re planning to get their newborn covered by Medicaid as soon as possible.
“I’m just hoping for the best,” she commented.
Health Insurance Viewed as a Luxury
Since its launch in 2010, the ACA has successfully lowered the uninsured rate in America from around 15% to about 8%, according to Nima Sheth, vice president of health justice at the National Partnership for Women and Families, a nonprofit group. However, experts warn that if Congress doesn’t act for the 22 million Americans benefiting from ACA tax credits, the number of uninsured could soar. The Congressional Budget Office projects that without an extension of these credits, an additional 3.8 million people could lack insurance each year from 2026 to 2034.
Most Americans need to enroll in an ACA Marketplace plan by January 15 to avoid gaps in coverage.
Without tax credits, premiums could jump an average of 114% for those who previously relied on subsidies. Michelle Sternthal, interim senior director of policy strategy at Community Catalyst, described the situation as a troubling policy choice that effectively makes insurance a luxury and leaves medical debt as a default condition.
Recently, the House approved a three-year extension of some expiring ACA tax credits. However, this bill now faces significant challenges in the Republican-controlled Senate, though lawmakers view it as a potential starting point for negotiations.
Heavy Financial Burden
Stacey Canas from Plantation, Florida, also receiving ACA tax credits, is contemplating going without insurance after witnessing her premiums soar to $2,500 monthly for her and her husband—more than double what they paid the previous year for themselves and their 20-year-old daughter.
“It weighs very heavily on me,” Kanas, 59, said. “My husband had major surgery not long ago. We definitely don’t want to be uninsured.” Although she feels generally healthy, the thought of a family member facing severe illness is concerning. “One more issue could turn into a disaster,” she added.
Experts suggest that even those keeping ACA coverage might skip necessary treatment to avoid the financial stress of out-of-pocket costs.
“When you’re underinsured with a high deductible, your coverage is almost designed to dissuade you from seeking care, even preventive measures, leading you to delay treatment until emergencies arise,” Sternthal explained.
Robert Myers, a consultant from near St. Louis, switched from an ACA silver plan to a bronze plan upon learning his premiums would jump from $17 a month to $400 next year. The new plan has no monthly premiums, but with an $80 co-pay and an $8,000 deductible, he could actually end up spending more out-of-pocket. This has led him to reduce his doctor visits, a behavior that experts say could see more individuals resorting to emergency rooms.
“They end up in the ER, get immediate care, but lack access to ongoing treatment,” Sheth noted regarding the trend.
Sternthal highlighted that this could have broader repercussions, as a rise in uncompensated hospitalizations could lead to higher costs for other patients while facilities try to recover their expenses. “Whenever delay happens, it not only pushes families to make health and financial compromises, but it also affects the larger business and community landscape,” she remarked.
