Health Insurance Woes in Vermont and Beyond

Alyssa Black, the chair of Vermont’s House Health Care Committee, finds herself at a crossroads. As a health care administrator, she understands the significance of affordable insurance. However, Black considered canceling her Obamacare plan after discovering her premium would jump to $1,144 per month, a steep increase from the $414 she paid last year.

“I don’t have that luxury,” she shared, expressing her concerns about the new premium. “It’s more than my mortgage and taxes…and that’s really scary to me.”

While Black managed to negotiate a raise at work to help alleviate her financial stress, many individuals aren’t as fortunate.

Recent data highlights this issue. Over 10,000 residents in Massachusetts dropped their insurance plans last month, nearly double the number from the previous year during the open enrollment period.

“When people lose their insurance, they don’t just vanish,” warned Rep. Stephen Lynch, a Democrat from South Boston. “The consequence is that more individuals are heading to emergency rooms.” He anticipates that this surge will worsen wait times for hospital beds, especially troubling in his district, where several hospitals are facing financial struggles due to the bankruptcy of Steward Health Care.

Lynch, along with other lawmakers, has fielded concerns from local hospitals about the rising costs of treating uninsured patients. The debate over whether to extend ACA subsidies found itself at the heart of last year’s tense budget negotiations with Republicans, resulting in a historic government shutdown. This stalemate ended in November when several Democratic senators reached a deal to reopen the agency without addressing the subsidy extensions.

Discussions about a new solution are ongoing. This month, 17 House Republicans sided with Democrats to vote in favor of extending enhanced ACA subsidies for an additional three years, despite opposition from House Republican leadership. However, the bill is currently stalled in the Senate.

President Trump has, so far, been hesitant to back the extension—even though the nonpartisan Congressional Budget Office supports it. The estimated cost is around $80 billion over the next decade, which would potentially increase the number of insured Americans by 100,000 this year, 3 million next year, and 4 million by 2028, according to the CBO.

Trump’s recent proposal to lower health care costs mainly focuses on introducing subsidies into health savings accounts for eligible Americans and reducing prescription drug prices.

For small business owners like Lucinda Crislip of Derby Farm Flowers & Gardens in Arlington and Newton, the end of ACA grants complicates staffing decisions. Many of her employees rely on the ACA for coverage since she cannot afford to provide health insurance yet. One of her seasoned florists mentioned that without extended subsidies, she might have to seek higher-paying jobs just to maintain health insurance. Rather than hiring extra help for Valentine’s Day, Crislip opted to give her florist extended hours to cope with increased insurance costs.

“We want to support our loyal, hardworking employees, but with inflation and rising prices, finding extra funds for wage raises is tough,” Crislip reflected, advocating for lawmakers across the aisle to negotiate and compromise together.

Her congressman, Democrat Jake Auchincloss, emphasized that the subsidy debate marks the beginning of a larger issue. “ACA subsidies are a short-term necessity,” he noted, “not a long-term strategy.”

This month, Massachusetts Governor Maura Healey announced a commitment of $250 million in aid to protect residents from soaring insurance premiums. Yet, Rep. Catherine Clark from Revere pointed out that this funding isn’t a sustainable fix.

“We need to bolster federal support,” added Clark, a second-place Democrat. “States have limitations, and we must continue to collaborate to prevent significant impacts on health care, hospital systems, and our community’s needs.”

Across state lines in Cranston, Rhode Island, small business owner Sara Cordero faces a monthly insurance premium of $1,036 for her family of four—an increase of $488 since last fall. This spike is forcing her to reconsider her financial ambitions, like launching a home inspection business, creating a college fund for her children, and buying a larger home.

“It’s like being Sisyphus, endlessly climbing a hill as the stones keep rolling back down,” Cordero expressed. “You feel like you’re making progress, but the goal just keeps moving further away.”

In Pembroke, New Hampshire, a 59-year-old semi-retired business owner has seen his insurance costs rise from $350 to nearly $1,000 monthly due to the loss of enhanced ACA tax credits. She’s managing, but it’s forcing her to cut back on other expenses.

“It introduced a constant low-grade anxiety into my life,” she admitted, wishing to remain anonymous to avoid potential backlash. “For those living paycheck to paycheck, it’s just intolerable.”

Rep. Maggie Goodlander from New Hampshire, which has one of the oldest populations in the country, acknowledged that many constituents are facing similar dilemmas. “This is a life-and-death matter for many who are forced to make difficult choices about their care,” Goodlander stated, emphasizing her involvement in a bipartisan group that supported the extension bill in the House.

She added that the increase in health insurance premiums only adds to the pressure of rising costs elsewhere, including utilities and housing.

Sen. Ed Markey of Massachusetts likened the tax credit expiration to a “ticking medical time bomb,” warning of dire consequences when Americans receive their insurance bills in 2026.

“People may have been preoccupied during the holidays, but the reality is setting in,” he remarked. “There’s a mix of anger and fear brewing among many.”

A previous version of this article inaccurately identified the town represented by Alyssa Black; she represents Essex County in Chittenden County.