Rising Health Insurance Premiums Raise Concern for Families

At the end of September, Laurel Vincenti got a letter from Blue Cross Blue Shield, letting her know that the subsidy that had helped cover most of her health insurance would be ending soon. This news means her monthly premiums, currently around $400, will likely increase significantly.

Laurel, 64, and her husband Philip, 62, from North Carolina, rely on the Affordable Care Act for their coverage. While they manage to pay their current premiums, there’s another $1,700 that’s being partially funded through a grant, which is also set to expire soon.

Both of them are self-employed, which adds another layer of stress. In 2020, Laurel was diagnosed with breast cancer, and in 2024, Philip had a heart attack. He’s still dealing with a hefty amount of medical debt, and their prescriptions alone cost them hundreds each month.

In light of the anticipated increase in premiums, Laurel decided to start looking for a new job this month, though she’s unsure if that will suffice to manage the rising costs.

“I was really frustrated when I got that letter,” she shared. “I had a feeling I might lose my subsidy, but I didn’t know how I would afford my insurance.”

The looming loss of enhanced subsidies under the ACA is part of the ongoing government shutdown discussions. Congressional Democrats are advocating for the extension of these subsidies, which were initially included in the 2021 American Rescue Plan, to gather support for reopening the government.

Open enrollment for ACA plans starts on November 1 in most states, and many people already signed up are receiving updates about their rates for the upcoming year. According to research from KFF, if the subsidies disappear, average out-of-pocket premiums are set to double—from $888 to $1,904 annually.

Lawrence Gostin, who heads Georgetown University’s O’Neill National Institute for Global Health Law, indicated that the negative impacts are already being felt.

“Even if they reach a deal to continue the subsidies, many individuals may still opt out due to the steep costs,” he noted.

Upcoming Premium Notifications

Insurers are expected to send renewal notices to those enrolled in ACA plans right as open enrollment begins, according to Adrianna McIntyre, an assistant professor at Harvard’s T.H. Chan School of Public Health.

These notices usually contain essential details about coverage and premiums for the next year, though some may lack thorough information.

“Many Marketplace subscribers should brace for some unpleasant news regarding their premiums later in October,” McIntyre commented.

While people might consider switching to plans with lower premiums, such changes could lead to higher deductibles, she warned. Navigators typically assist individuals in navigating these decisions; however, cuts in funding for ACA enrollment efforts earlier this year could hinder their ability to help.

This year, over 24 million individuals are enrolled in ACA plans, with about 90%—around 22.3 million—receiving enhanced subsidies. An analysis suggests that roughly 4 million people may lose their coverage by 2026 if the subsidies run out.

Jeff Feldman, a 60-year-old musician based in Phoenix, is contemplating giving up reporting next year.

Recently, he received a letter from HealthCare.gov stating that additional financial assistance linked to the pandemic will end on December 31, 2025.

The letter indicated that while he would qualify for financial aid in 2025, he would likely face higher costs for his marketplace plan in 2026.

Feldman estimates that his monthly premium could jump from $300 to $900, while his annual deductible remains unchanged at $9,000.

“They really priced me out of the market,” he remarked. “With two jobs, I’m thinking about picking up driving gigs with Uber and Lyft just to make ends meet, but even then, $900 a month feels impossible.”

Instead, he plans to skip insurance altogether next year and save the money he would have spent on premiums for unexpected medical expenses.

For some other families, the premium increases are not as extreme but are still significant. Wesley Hartman from Chatsworth, California, received a notice from Covered California stating that without the tax credit, his premiums will increase from $1,212 to $1,450.

While he mentioned they could manage the rise, it would mean cutting back on expenses for an emerging IT business they started a few years back.

“You can’t really expand your business or invest in tools that could help,” he shared, feeling both frustration and resignation upon reading the letter.

“People often say that America thrives on small businesses,” Hartman added. “We’re all trying to play our part, and honestly, it feels like there’s not much we can do.”