Health insurance costs have risen for many individuals, particularly as ACA subsidies are set to expire, prompting some to grapple with the difficult choice between expensive plans or going without coverage.
GRAND RAPIDS, MI — Rebecca Perrin was taken aback when exploring her healthcare options this year.
“I couldn’t believe my eyes,” Perrin remarked. “I thought, ‘This is outrageous. Who can actually pay for this?'”
This sentiment is likely shared by many Americans as the Affordable Care Act (ACA) subsidies come to an end on January 1st.
Residents in Wyoming who depended on tax credits to manage healthcare costs are among the millions now faced with escalating premiums and limited choices.
As noted in the Affordable Care Act, close to 24 million individuals—including over 500,000 in Michigan—are insured through this program, according to the Centers for Medicare and Medicaid Services.
A report released in September by a research institute projected that around 4.8 million individuals could lose their health insurance if the enhanced premium tax credits disappear.
With the expiration of this subsidy, many, like Perrin, find themselves having to make tough decisions: opt for a more costly plan or risk going uninsured.
Perrin, who lost her Medicaid eligibility last year, started purchasing insurance through the ACA in 2023.
“It was fairly affordable,” she said. “I was paying around $30 monthly, which even covered dental. My out-of-pocket expenses were manageable, about $10 for a regular visit and $20 for a specialist. Medications cost just a few dollars.”
However, her premiums increased last year, and this year’s options left her in disbelief.
“My original plan was taken off the table, so they suggested an alternative,” she explained. “This new plan was going to cost $450 a month.”
In the end, she found a less expensive alternative, but it was through a company she had never heard of, which had limited reviews and significant drawbacks.
“A monthly fee of $11 or $12 seems appealing, but there are hidden costs. With the deductible, it totals around $17,000,” Perrin noted. The consultation fee for a gynecologist alone is $200.
More affordable plans often weren’t accepted by her doctors.
That’s why she thinks going without insurance may be the only feasible route.
“I have a full-time job,” Perrin said. “Actually, I’m considering changing jobs, but I’m worried about burning out and racking up hospital bills. It feels unfair.”
According to Marianne Udo Phillips, a lecturer at the University of Michigan School of Public Health and a senior advisor at the Center for Health Research and Transformation, “In many cases, the end of these enhanced subsidies has nearly doubled premiums.”
This growing uninsured population will impact everyone, including those with employer-provided coverage, she added.
“This year, more individuals will lose their insurance, and hence, there will be a rise in the uninsured. People unable to pay their bills will increasingly seek hospital care,” Udo-Phillips explained. “This situation will lead to higher premiums for everyone who maintains insurance.”
Health insurance costs have climbed overall due to various factors, including skyrocketing prescription prices, inflation, and the increasing demands placed on the medical system.
“This situation poses a significant challenge for a lot of people,” Udo-Phillips said. “Even if many qualify for some sort of subsidy, it won’t be comparable to what they’ve traditionally received.”
Annual premiums for employer-sponsored insurance have surged by 6% compared to the previous year, according to the Kaiser Family Foundation.
The Senate is scheduled to reconvene on January 5th, while the House will return on January 6th. Funding the ACA subsidies will be a top issue during this session.
Last fall, disagreements between Democrats and Republicans over this matter contributed to one of the longest government shutdowns in U.S. history.
Perrin has a straightforward message for federal lawmakers.
“We need a solution, and we need it now,” she stated. “What if I require surgery? Or if I break a bone? What if I need to see a specialist? That’s frightening.”
“When this happens, I don’t feel safe leaving my home.”
