Millions of Americans are grappling with surging health insurance costs as open enrollment for 2026 coverage begins. The end of expanded subsidies under the Affordable Care Act (ACA) has led to significant increases in premiums, with many experiencing drastic changes in their health insurance options. Previously, subsidies capped premiums for benchmark plans at 8.5 percent of income, helping approximately 22 million individuals at an annual cost of around $35 billion. As these expanded benefits expire at the end of this year, many are left with limited choices and rising expenses.
The situation has created a climate of anxiety among prospective enrollees. For instance, Jeff Rowan, a retiree in Colorado, reported that his premium for a health plan on the state insurance exchange soared from $350 to nearly $900 a month. Consequently, he switched to a pension plan costing $700, reflecting a 100 percent increase from last year, which he previously deemed outrageous. Rowan stated, “The fear of something unexpected happening and my moderate savings being wiped out is forcing me to pay the piper. It’s a completely fear-based decision.”
Similarly, Galen Perkins, a small-business owner in Wisconsin, recalled a prior mistake of opting out of insurance, resulting in an expensive visit to the emergency room. He now faces a 25 percent increase in his ACA premium but plans to adjust his budget rather than forgo coverage. “We’re just going to buy food, pay rent, pay health insurance, and that’s it,” Perkins said, noting concerns about the economic impact of such cutbacks.
Many individuals are reaching out to their elected officials for assistance. Representative Seth Magaziner (D-RI) has received reports of “staggering” premium hikes from constituents. One retired marketing executive, Susan, shared her experience of facing a premium increase from $600 to $2,120 per month, marking a staggering 250 percent rise. Another constituent, Sarah, a small business owner, reported her premium would jump from $536 to over $1,000, an 89 percent increase. Magaziner emphasized, “Americans cannot afford these price increases. These spikes will break household budgets in Rhode Island and across the country.”
Concerns are echoed by Senator Michael Bennet (D-CO), whose staff reported receiving over 3,200 messages from constituents regarding escalating health care costs this month. Bennet highlighted that working families are already struggling with rising costs in other areas and urged for an extension of the ACA premium tax credits to alleviate this financial burden.
The political landscape is also shifting, with former President Donald Trump advocating for direct financial support to individuals rather than traditional insurance models. He stated, “THE ONLY HEALTHCARE I WILL SUPPORT OR APPROVE IS SENDING THE MONEY DIRECTLY BACK TO THE PEOPLE,” emphasizing a desire for more consumer power in the health insurance market.
Republican lawmakers are reportedly exploring alternatives, including proposals for flexible savings accounts that would allow individuals to negotiate prices directly with health care providers. Critics argue that this approach may not address the underlying issues, as most individuals would likely funnel funds back into insurance companies, which dominate negotiations in the current system.
The termination of ACA subsidies without a comprehensive strategy raises serious concerns about the future of health insurance coverage in the United States. Dr. Vikas Saini, president of the Lown Institute, a nonpartisan health care think tank, warned that many healthy individuals may opt out of insurance entirely. This could lead to a higher average risk pool among those remaining insured, resulting in increased costs for insurance companies, which may then pass these costs on to employers offering coverage.
For individuals like Taylor M., who works for a health care provider in central New York, the financial strain is palpable. Taylor noted that while his employer-provided insurance is increasing by 30 percent, the cost for co-workers covering their families has risen from approximately $600 to $700 per pay period. “On some level, people may not have realized that this is what they were voting for,” he reflected, linking the rising costs to broader political decisions.
Others, such as Sam from Portland, Oregon, are also feeling the pressure. Faced with an ACA bronze plan costing about $420 a month—excluding essential medications and primary care visits—he had to pivot to his wife’s private insurance, adding another $500 monthly expense. With the family’s overall monthly costs reaching $2,600 due to losing access to food stamps and free childcare, the situation has become increasingly dire. “It’s just so brutal,” he expressed, highlighting the challenges of affording basic needs amidst a healthcare crisis.
As the open enrollment period unfolds, the implications of these rising health insurance costs will likely resonate beyond individual households, impacting the broader economy and health care landscape. Many Americans now find themselves navigating a complex and costly system, raising questions about the future of health care access and affordability in the United States.
