Families Face Tough Choices Amid Rising Health Insurance Costs
Soaring health insurance premiums force families to make difficult financial decisions. Many are downgrading plans or going uninsured as costs rise.
Ken Warner, a sci-fi and fantasy author, shares his home office in Manchester, Conn., with his cat Ostara. Together with his wife, Parveen Vohra, a mental health counselor, they rely on HealthCare.gov for their health insurance.
The couple, both in their mid-50s, faced significant expenses in 2025, including a new roof, a boiler, and two surgeries—Warner’s hip replacement and Vohra’s eye surgery. Despite having a good plan through the Affordable Care Act (ACA) marketplace, they incurred considerable out-of-pocket costs.
To manage these expenses, they depleted one of their two small retirement accounts accumulated from previous employment before transitioning to self-employment.
This year, they are bracing for more financial strain. Following the expiration of enhanced federal subsidies for ACA plans, their monthly premiums increased dramatically.
“In 2025, we were paying $630 per month for both medical and dental coverage. Now, it's $2,531.07,” Warner states, emphasizing the burden of a cost comparable to an average U.S. mortgage payment. “We can't afford that—who can?”
They had hoped for a congressional agreement to extend the subsidies. Although a bipartisan three-year extension was passed by the House, subsequent negotiations failed, leaving families like Warner and Vohra facing new financial challenges.
The ACA marketplaces had seen increased enrollment, with 24 million participants last year. However, as enhanced subsidies ended, average premiums doubled, according to KFF, a nonpartisan health policy organization.
A recent KFF survey revealed that while 70% of enrollees retained their marketplace coverage, many downgraded their plans or opted out of insurance entirely due to rising costs. “When we ask people about their reasons, cost is a recurring theme,” says Ashley Kirzinger, director of survey methodology at KFF.
To cope with escalating premiums, many enrollees are making difficult choices. Over half reported reducing household spending, including groceries, and some are taking on additional jobs or accruing debt to manage healthcare costs.
As the months progress, the number of individuals who drop coverage may increase. Kirzinger noted that nearly one in five enrollees are uncertain about their ability to pay premiums throughout the year, raising concerns about potential uninsured rates.
Federal data shows a decline of over a million enrollees in ACA plans for 2026 as of mid-January.
Warner and Vohra recently reviewed their budget to identify potential cuts, resulting in changes such as switching cell phone plans, canceling streaming subscriptions, and halting house-cleaning services. “We’re not doing any vacations, which are beneficial for mental health,” Vohra says, acknowledging the sacrifices made to manage their new insurance costs.
Both are also exploring ways to increase their income. Vohra is fully engaged with her counseling practice while also caring for her elderly mother. Warner is crowdfunding for a special edition of one of his fantasy novels and seeking jobs that offer health benefits, although he has yet to find success.
If they earned less, they might qualify for subsidies, but earning more could make the premiums manageable. They are also concerned about future surgeries—Warner's remaining hip and Vohra's other eye—and the possibility of tapping into their last retirement account.
“Now we’re considering that,” Vohra admits, expressing concern over their financial future. “This is supposed to be for our 60s and 70s.”
With the rising cost of long-term care for Vohra’s mother at approximately $10,000 per month, they worry about affording such care in their later years, especially if premiums continue to rise.
Warner anticipates further increases, estimating a potential 10% to 20% hike next year. “It’s going to get worse; this is not a one-time issue,” he warns. Both feel trapped in a flawed system. “It has been infuriating to see this situation deteriorate,” Warner reflects. “It feels like we’re being robbed, as if our financial security is being taken away.”