As enhanced ACA subsidies expired at the end of last year, middle-income Americans are facing a crisis. The enhanced ACA subsidies, which had helped millions of Americans cover all or part of their marketplace premiums since 2021, expired on December 31. With the loss of the subsidies and health care costs already surging, more middle-income people face difficult decisions about their health coverage. According to a January poll from KFF, more than 80% of Americans said their cost of living has increased in the past year, and about two-thirds are somewhat or very worried about affording health care—more than said the same about other necessities, such as food and housing.
Real Stories of Financial Strain
Noah Hulsman, who owns a skate shop in Louisville, Kentucky, learned he no longer qualified for federal subsidies. The 37-year-old opted for skimpier coverage, but the deductible of $8,450 is about a quarter of his yearly income of approximately $33,000. Last year he paid about $105 a month for a gold plan with a $750 deductible. This year, paying the same monthly premium for a bronze plan, he faces a deductible of $8,450 before his insurer starts paying for care.
Loretta Forbes, 56, realized she would have to drop her plan after her monthly ACA marketplace premiums jumped from $250 to $2,500 in 2026. The woman with rheumatoid arthritis near Nashville, Tennessee, started rationing her medications. Her husband, Jim, 59, gave up his handyman business and started looking for a job with insurance coverage. The day before their coverage lapsed, Jim got a job offer at a property management company with health benefits. Forbes subsequently learned she was approved for Medicare because of her disability, with a monthly premium of $155.
Nicole Wipp, 54, a self-employed lawyer in Aiken, South Carolina, learned that her family’s ACA plan monthly premium would be more than their mortgage payment. Her plan would have cost $1,400 per month, up from $900 last year. She and her husband dropped their family plan and bought coverage only for their 15-year-old son, paying around $200 instead. Wipp, who has a rare lung condition, plans to pay out-of-pocket for preventive care and relies on an old health savings account for larger medical expenses.
Broader Impact
Already about 1.2 million fewer people have signed up for plans for this year under the ACA, according to federal data. Health policy analysts expect more people to stop making payments and drop coverage in the coming months. ACA marketplace premiums jumped an average of 26% in 2026, attributed to higher hospital costs, the popularity of pricey GLP-1 drugs for obesity and diabetes, and the threat of tariffs. Nearly 4 in 10 adults said they were skipping or postponing necessary care because of costs, according to a 2025 KFF poll.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.canoncitydailyrecord.com/2026/02/12/when-health-insurance-costs-more-than-the-mortgage/