In Colorado, Astrid Storey, a thyroid cancer patient with an autoimmune disorder, faces a significant increase in her monthly health insurance premiums under the Affordable Care Act (ACA). Starting in 2026, her premiums are set to rise by nearly $500, prompting her to consider leaving the United States for a country with universal health care. Storey, a naturalized U.S. citizen originally from Panama, expressed her frustration, stating, "The American dream is a disappointment when it comes to health care."

Storey is not alone in her concerns. Nathan Boye, a Florida resident with diabetes, has been informed that his monthly premiums will jump from $28 to over $700. The married father of three is now contemplating dropping his health insurance altogether. Doug Butchart, a retired mechanic from Illinois, is also struggling. His wife, Shadene, suffers from amyotrophic lateral sclerosis (ALS), and he has received notice that her ACA premiums will increase to $2,000 per month. With an annual deductible exceeding $8,000 and additional out-of-pocket expenses, Butchart's wife's health care costs will surpass his monthly Social Security income.

Currently, about 22 million of the 24 million ACA marketplace enrollees benefit from enhanced premium tax credits, which were expanded during the COVID-19 pandemic under the American Rescue Plan. However, these tax credits are set to expire at the end of this year, leaving many policyholders facing unaffordable premiums unless Congress intervenes. The issue has become a point of contention in ongoing political negotiations, contributing to the longest government shutdown in U.S. history. Democrats are demanding an extension of the ACA subsidies, while Republican leaders insist on passing a clean funding bill first.

Storey, who runs a small business in Denver, does not receive ACA tax credits. She shared a notice from her insurance provider, Blue Cross Blue Shield, indicating her premiums will rise from $1,400 to nearly $1,900. "I have very specific needs as to which doctors and which medicines I needed to have covered in this plan," she said. To help manage costs, her husband has taken a part-time job at Starbucks. Storey warned that if her premiums reach $2,500 a month, she and her family would consider selling their belongings and leaving the country.

Boye, who currently pays $28 a month for his ACA plan, faces a staggering 2,518% increase in premiums. After researching options, he found a plan with a $113 monthly premium, contingent on a $620 tax credit. Boye, who was laid off earlier this year, is also pursuing a degree in business administration while working part-time. He expressed concern about the potential loss of tax credits, stating, "I gave up on the idea of having health care."

Butchart and his wife recently traveled to Washington, D.C., to discuss their situation with congressional leaders. He shared that his wife's ACA premiums will rise from $603.82 to nearly $2,000 without tax credits. He described the situation as "insane," noting that his wife's primary medication costs about $15,000 a month. Without the tax credits, their out-of-pocket expenses could exceed $10,000, which is more than their annual income.

In response to the rising costs, Anthem Blue Cross Blue Shield stated that their rates reflect expected care utilization among ACA members, which has increased significantly. They noted that ACA members use emergency rooms at nearly double the rate of those with employer-sponsored coverage. Florida Blue also acknowledged that higher insurance costs are anticipated next year, attributing them to the expiration of enhanced premium tax credits and rising medical care costs.

As the deadline for re-enrollment approaches, many Americans are left uncertain about their health care futures. Storey, Boye, and Butchart's stories highlight the urgent need for a resolution to the ongoing political stalemate affecting health care affordability in the U.S.