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As Insurance Prices Rise, Families Puzzle Over Options

Millions of middle-class Americans who have Affordable Care Act marketplace plans are facing soaring premium payments in 2026. Some people are contemplating big life changes to deal with new rates that kicked in on Jan. 1.

Summary of reporting by kffhealthnews 2 min read Markdown

Millions of middle-class Americans with Affordable Care Act health plans are facing soaring premium payments in 2026 without enhanced subsidies that Congress failed to renew. Some families are contemplating significant life changes to manage the sharp cost increases that took effect January 1.

New York-based performer Cynthia Freeman, 61, and her freelance husband Brad Lawrence, 52, saw their “silver” plan cost rise nearly 75% to $801 a month in January. Lawrence was hospitalized in October after rapidly gaining 25 pounds in five days and experiencing chest pain and breathing difficulty. Doctors diagnosed him with kidney disease requiring medication averaging $760 a month without insurance. Freeman picked up a part-time bartending job to bring in extra cash.

Families face difficult choices. One Rhode Island mother, identified as B. to protect her job search, was looking for employment with benefits because the premium for a “gold” plan was nearly $2,000 monthly. Her family’s plan would have cost almost $3,000 in 2026 without subsidies. She had already withdrawn $12,000 from retirement savings to pay 2025 rates. She ultimately decided to purchase a plan on the ACA marketplace for herself and her husband at $1,200 a month while her children qualify for free Medicaid coverage. “The bottom line is none of this is affordable,” she said.

Another family postponed a wedding. Nicole Benisch, 45, a holistic wellness business owner, had planned to marry December 19 on her late mother’s birthday. Her zero-deductible “silver” plan cost $108 monthly but would more than double to $220 in 2026. As a married couple, their combined income would exceed the subsidy eligibility threshold, tripling her premium to over $700 monthly. Losing Rhode Island doctors to her fiancé’s Massachusetts network presented another barrier.


This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://kffhealthnews.org/news/article/aca-obamacare-premium-payments-prices-marketplace-plans-hard-choices/

Original report

As Insurance Prices Rise, Families Puzzle Over Options
kffhealthnews

About this article

  • Educational, not advice. Nothing here is medical, legal, billing or financial advice. Clinical decisions belong with a licensed clinician; coverage and legal questions belong with the payer, the statute or counsel. Prices and rates change; confirm them with the provider and the plan.
  • Corrections. If something on this page is wrong, send a correction with the source.

Topics: health-equity

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