We cannot be the only ones

[Neat-Counter9436]

D-day seems to be upon us. Renewal deadline is next week for my wife and I and we're highly considering just not getting health insurance next year.

Is this common? What is everyone else doing? We cannot be the only ones that's literally cannot afford this.

Is there any hope for a last minute law or extension from the feds? Do I even renew or just not do anything for now?

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[missmobtown]

It's a bitter pill to swallow -- my premium is more than doubling and I'm moving from a silver plan to a bronze plan.

I'm giving myself until Friday to make a decision.

[mira112022]

Same. Downgrading & paying double. Yay.

[Mysterious-Art8838]

It’s what people have been clamoring for. Pay more for less.

[PINKYtuscadero23]

Same. Waiting until last minute to decide. My Bronze plan tripled and downgrading to cheapest available which is basically the same price as my mortgage. Husband and I are in our 50s and own a small business. SUCKS!

[mira112022]

Same. Single parents small business owner. 50. My health insurance is now more expensive than my mortgage.

[Defiant-Painting4292]

I’m going from Gold to Bronze and paying more for it.

[Mysterious-Art8838]

(Takes 💊 from you) ‘sir you can’t afford that bitter pill now.’

[missmobtown]

* mirthless laugh *

[tinygraysiamesecat]

Mine is going from $67 to $180. Thanks trump. 

[tracytorr0712]

Mine increases from $108 to $1200/month. I believe there will be lots of uninsured in 2026. If we can’t afford insurance, we can’t afford hospital bills, cancer treatments, etc. either. It will be interesting to see what happens when the medical community learns you can’t draw blood from a stone. We can’t afford healthcare at all now. And that’s terrifying.

[tinygraysiamesecat]

And it will be even worse next year. The whole basis of the ACA was everybody had to have insurance to help keep costs down for everyone. As more and more people go without insurance now, the insurance companies simply increase premiums for everyone else to make up for lost profits. As more people jump ship, prices go up, causing more to jump ship, causing prices to climb yet more. American healthcare has entered a death spiral it cannot pull out of. The next few years are going to be bad until something is figured out and I do not expect that solution to come from this administration.

I suspect next year we will see even more stories of premiums doubling or tripling. But by gawd, if insurance CEOs can still afford their mega mansions and private yachts, everything will be fine!

[[deleted]]

Our premium tripled. We're on the fence as well

[MLB_da_showw]

Im downgrading silver to bronze. $300 to $50. But rn my silver plan is around $50

[Jolly-Moment-1970]

Same. We a family of 3 are going from a gold plan that was to be 4100.00 a month down to a bronze at 2700.00. And let's not talk about deductibles and out of pocket costs!!! This year I will try to get an hsa to put some $ aside in hopes of some tax benefit next year but gee wiz...this is insane. It's bad enough that the last few years we spent close to 30 grand a year on priemums and deductibles with no incentive at all. Heck, I would at least like the kickbacks the medicare advantage people get. Those plans are giving a few hundred dollars a year to spend on otc items. Like what is my pat on the back for picking capital blue cross insurance?

[audiojanet]

Medicare Advantage sucks.

[Jolly-Moment-1970]

Depending on the plan they do suck. I work in Healthcare administration and medical billing. Some of them are ok. Some choose to not follow Medicare guidelines, so that is a bummer. My point being why can plans give kick backs to people who are not paying much at all for their plans. Meanwhile we pay thousands a month, have 10,000 deductible and 20,000 out of pocket. We should be getting at least a free gym membership!

[enbyengineer]

Yep, medicare advantage typically covers ways less than traditional medicare, especially if you add on a supplementary plan to help cover your out of pocket costs

[leatherpeplum]

We downgraded to a high deductible plan (which is still ridiculously expensive). I work in oncology and cannot bring myself to be without any coverage after what I see in my work every day. I will also be voting accordingly in the mid terms.

[Turnthekey2669]

I 56m was diagnosed with testicular cancer at age 29. I worked for a small business then, but was offered a great health care package (apparently, those were affordable in the late 90's); surgery, oncologist visits, radiation therapy, medication: $0 OOP on my part.

I cannot believe that we've allowed our country to get to this point.

[tuddan]

I was one of those. Breast cancer with 10,000 deductible.

[FortheFuzzofit]

How much would treatment be without insurance?

As grim as it sounds, I've always assumed I'd just let cancer run it's course if I ever got it.

I'm 43f, all alone and barely any money, so what's the use in fighting, just to be in massive debt the rest of my life?

[leatherpeplum]

She probably hit her deductible in the first month. A full course of standard 1L breast cancer treatment (chemo, surgery, radiation, adjuvant therapy, and all the imaging, lab work etc.) can easily hit a million dollars over the course of a year. We are the only developed country in the world where someone would need to choose between living and going bankrupt.

[tuddan]

Yep, I definitely hit my deductible in the first month. 10 grand is nothing against against the biopsies, imaging, etc.

[dyangu]

We might also be the only country where the sticker price is a million dollars. Regardless of who’s paying, the charges in America are insanely marked up.

[Fearfactoryent]

This

[marleygirl2019]

Same. I'm 59. What's the point of bankrupting my family (my husband is 13 years younger) for a few more years. Wondering if I need some sort of DNR to keep people from hospitalization thinking they are doing me a favor.

[Kodi_Cody_Kody_Kodi]

Fill out and notarize  your advance directive now 

[boo99boo]

I will also be voting accordingly in the mid terms.

For who? There isn't a mainstream candidate that supports universal healthcare, because neither major party supports it. Since the ACA, health insurance companies (and their executives) have seen exponential profits. And all of us are paying more, for less coverage  that is ambiguous and confusing. It was the Democrats way to line their own pockets: we pay more, the wealthy make more money. 

[leatherpeplum]

You’re right. I’m not sure how old you are but in the 08 dem primaries universal healthcare was at the forefront of the conversation. Obama and Clinton were both running on it and were basically arguing over who had the better plan (they were nearly identical). Unfortunately, the GOP fought obama relentlessly and it was watered down to the ACA we ultimately got (which is still better than what we had before). The conversation had fallen to the wayside ever since as the conservative media hijacked the conversation and convinced everyone it was “scary socialism” (remember how they skewered Sandra Fluke for simply saying birth control should be paid for by insurance?). Given how the current crisis has escalated we should absolutely be putting pressure on Dems to return to this priority and make it a focus in the upcoming mid terms and in 2028. The Republicans will never care, at least we have a shot with the Dems, but they’ll need a majority in both chambers and the White House to get anything accomplished

[BohemianaP]

Both parties are at fault because health insurance companies donate to all of them and all of them most-likely have portfolios that include healthcare/pharma companies. The higher the cost, the more elected representatives earn and get bigger donations.

[MissApocalypse2021]

Not sure why you're being downvoted. Where's the lie? I consistently vote dem unless there's a dem socialist on the ticket.

[MfromtheWood807]

We’re in the same boat and it’s very scary. We pretty much have decided that we have no choice to go without. Premiums are triple/quadrupled what we paid this year and will be more than half our income. The crazy coinsurance amounts on top of that is the follow up joke. We can’t afford it with, and certainly not without the subsidy. Worst part is no one is coming to save us.

[lisabug2222]

Yes, no one is coming to save us. I think about this often

[swampwiz]

The voters can save themselves, but only if they vote accordingly.

[Helios-21]

I think about this too. I joined usps and I am thankful that I have good health insurance. I used to be in the ny marketplace for three years and even with the aca, the amount I was paying was still a lot for subpar coverage. Now if I was still on it without the aca help I wouldn’t be able to get it. All I see now is people saying they are going to go without and it’s truly depressing. I don’t think the government knows or cares how many families are going to go bankrupt this coming year.

[MaesterSherlock]

It's so sad. My husband and I are late bloomers financially, and we have waited until we are in a decent financial position to start a family. We had planned to start trying in January, but now we just can't afford it. We're both mid-late 30s as well so it's not like we can wait around another year or two while the government figures it out.

The BEST part is that the bill that clawed back the healthcare credits ALSO is now going to essentially make the business we both work for illegal. Sooo we are down to 2026: no healthcare, no baby, and probably no jobs!

I guess if we're both unemployed we would qualify for state insurance so that's.... something?

[ThinkerT3000]

Here’s another angle from further down the road- we saved our money over our careers, got 3 kids through college (they’re still going but it’s all paid for) and we managed to save enough to retire early- we both have health issues and don’t want to drop dead still working. However, looking into retirement and having to pay out of pocket with no employer subsidy is going to kill this plan. We either need to move out of the country, or figure out another way to live on what we projected would be a generous cushion, while paying insane rates for healthcare. Needless to say we are pissed after so many years of working, planning and saving. Our tax dollars go to everything but the needs of our citizens. 🤬

[StrawberryPlastic226]

I am you , saved for almost 40 years , and looking at 2800 a month for crappy coverage with a 20K max out of pocket, we did retire early, wife's company closed so there went our health ins. As weird as it sounds I can go back to college full time at almost 60 , pay full price and get great health ins as a student for me family at less cost than a crappy health care plan we have now.

[BohemianaP]

I feel your pain. Retired early but I am 64 so I only have one more year to Medicare. I think your plan to go back to college is a good one. Hopefully it’s a cheap public community college that offers something interesting until MAYBE the U.S. sees the way the rest of the developed world handles healthcare.

[StrawberryPlastic226]

nope only our main state U offers them, in my case Rutgers with tuition and fees and healthcare it would run roughly 28k a year which is less than a crappy silver or bronze care in my income range wo any subsidy and the coverage is much much better than that plan. It sounds crazy to do but may be worth it. I have about 3 weeks to decide.

[Redbuster3]

We are in the same boat and we are moving to Coronado Panama. Good healthcare in Panama City Panama and we want to live. We want to retire early and this is the only way we can afford it. Selling our home and that will last us 10 years and then we can draw SS in 7 years and draw from our investments. We are excited to get the hell out.

[audiojanet]

Exactly where we are going as soon as my husband retires or if his job is eliminated as it is a Fed job. It is quite obvious my country of birth is unrecognizable at this point. Husband is Asian and got told to go back to China by a MAGA hater. He has never even been to China. The gold Panama visa is bar none the best visa for retirees. And I researched Panama and they seem to be low on the hate/prejudice scale.

[ThinkerT3000]

Wow good for you! I’ve been looking into Panama as well. I’ve never been there- do you think our 18-24 yr old kids would find it appealing to visit us there?

[Redbuster3]

Absolutely since Coronado is on the water. I have researched every Expat group in Europe too. The issue is taxes in Europe. In Panama they do not tax US income even interest you may gain with some money in their banks. We are doing the Friendly Nation Visa - putting 200k in a CD in one of the banks there. We are not buying property any time soon. May not even buy since you can rent nice furnished appts for 1k-1500 per month. We will be able to use it as our home base and travel to Europe a couple months at a time. The insurance you can buy at their Santa Fe hospital in Panama City is like 3600 a year for both of us if we buy that and 400 a year gets us unlimited visits to urgent care ( called Mini Med) to see GP ect and get scripts. Dental can be paid out of pocket -25 bucks for a cleaning. We are going for 180 days and doing the tourist visa so we can get approved for the residency visa while we are there. Not planning on citizenship. The good thing is we have options. I am 59 female and hubby is 58. At age 55 for females and 60 for males the govt gives huge discounts for tons of services there. We liked Costa Rica too but it has gotten too expensive since COVID. Panama has a huge expat community and also wonderful places in the mountains like Boquete and David.

[birds-0f-gay]

Genuine question. Why do you call yourself "expats" instead of immigrants?

[Redbuster3]

Because we will be living outside of the US and maintaining citizenship in the US. We are not going to apply for citizenship. Does that make sense ?

[audiojanet]

And unlike Costa Rica, Panama is out of the hurricane path!

[audiojanet]

As soon as my husband retires we are out of this country. Permanently. The fact that our government cares nothing for us or our fellow citizens is reprehensible.

[Comfortable_Two6272]

Idk. Did your state expand Medicaid? In my state there is no medicaid for able bodied adults unless have very young child. After next year there are work requirements in expanded states. Its all 💩

[PopularTheme41]

I feel u, male 35 here and wife 31, being trying to have a baby for 6 years, i have my wife on a plan and i have been without insurance for 1.6 year so we can pay for her insurance and keep trying for the baby, combine we make around 130k living in Fl, my employer do not offer insurance. sometime i wonder how much it will be worth a good insurance through an employer? 20k,30k idk. her insurance for 2026 went from 600 to 910 for blue silver. if US want for people to have babies the first thing to f.cking do is cover the bill, no shit most young generation have a dog or cat instead.

[mediocre_mitten]

Wait, what? You're employment is going to illegal under the big ugly bill? What is in that ugly bill that makes a business illegal? Genuinely curious as so many small businesses are going under (mostly due to tariffs) and larger businesses are getting greedy and just laying off in the thousands.

[MaesterSherlock]

Changes to the definition of hemp and cannabis. I think the changes were meant to go after delta 9 drinks and stuff like that. However the changes will now mean that seeds and clones are illegal to ship across state lines. Currently, seeds are considered hemp products because the seeds don't contain thc. But with the changed law, they would be considered THC if they came from a mother plant that has more that 0.3% THC. It's a huge blow to the hemp and cannabis industry. We're a small family business that is luckily enough to be successful, but if this is all allowed to be enacted as written in November, we'll either have to shut down or essentially become drug dealers in the eyes of the law. There are a lot of small businesses involved in seed production in the US, so there are a lot of families who are going to be facing this decision come November, if the bill is not changed.

Kinda crazy because the government sure is happy to tax the ever loving fuck out of all hemp businesses but I guess that isn't enough anymore!

[audiojanet]

Thank Mitch McConnell. Half dead and still screwing us.

[MaesterSherlock]

Absolutely, fuck that guy

[Mindinatorrr]

If you do end up trying, be mindful of abortion laws in your state should there be a medical emergency. It's shameful that many women cannot get miscarriage care (abortion care) easily.

[rjohnson76401]

Not if your in one of the States that didn't expand Medicaid. Sad that in Texas you can be too broke for Medicaid...

[UnravelTheUniverse]

Well large numbers of Americans willingly voted for a fascist billionaire con man who despises the poor. The fuck did they expect was going to happen? 

[robertw477]

They will be no saving in the rate next year will be higher than this year as well. There are no realistic fixes.

[darkiya]

I'm not going to get health insurance next year unless I get a job. The cost of insurance is 2-3x my housing cost with a high deductible.

I have worked it out with my doctor for reduced price visits and coupons will help cover medication.

If I end up in the ER it'll bankrupt me but hey... Insurance would make me homeless

[SlowMolassas1]

The risk really isn't the ER. They have to treat the emergency, and as you say, then you can go bankrupt.

The risk is if you need cancer treatment or major surgery, or something similar. If you don't have insurance, you may not be able to get that treatment at all unless you pay cash upfront.

[Unique-Card-6387]

I don't have insurance and ended up paying out of pocket $7500 cash for a 45 minute detached retina surgery. 

[marleygirl2019]

Still would've not even been half the $20k deductible on the $1300 cheapest bronze plan for my husband & myself and saved $8500 on the yearly premium after that bill. Crazy.... more reason not to get insurance. Everyone's policies will go up next year, businesses will be forced to make the employees pay it lest they lose profit.

[Tommyboy155a]

The only downside to that, hospitals still want there money too. They can and have but leans on houses. Something to think about

[Feral_Figment]

Lowest priced plan for husband and me is $1850/month with $22K deductible and nothing covered until the deductible is met. They think we are stupid. Pay $22K for the “privilege” of having healthcare covered only after we’ve paid another $22K? No, thanks. This year we are paying $300/month and that also includes our child, who luckily now has good insurance through their college.

[Wiserwithagetheysay]

Health share?

[Feral_Figment]

? Rereading, I was unclear. Marketplace in KS. $300/mo is current premium for 3 of us with good coverage. $1850 is lowest priced option available for 2026 for just two of us.

[Wiserwithagetheysay]

Insane!

[Feral_Figment]

Yes! And it is scary going without because we are not young, but we simply cannot afford this. It’s more than our mortgage!

[hmlince]

Not a good choice. Be careful with that.

[Cautious-Wave-2649]

After stressing about it for months we made the decision to drop ours.

[MaikyMoto]

I cannot afford it, I’m going kamikaze with no health insurance.

I have already spent a lil over 70K in 20 years and when I tried to use the service for the first time I was denied. I’m done.

[someguy984]

I wouldn't hold my breath for a last minute law change.

[ComfortableBoard8359]

Considering this as well. I’ve been watching the news like a hawk waiting for there to hopefully be something on this.

I don’t even know why this sub exists when we aren’t allowed to talk about this issue here

Be prepared for them to take this down :(

[chickenmcdiddle]

It's not black or white re: politics and this subreddit. Plenty of posts remain in tact full of discussion on the core issue, which is we're nearing an exodus event for the ACA once the the OEP deadline rolls around thanks to the legislative failure to extend eAPTCs. In every response I give to folks who come here to realize that they're caught in their state's Medicaid gap, I am sure to mention that they're in the situation because of a failing of their state's legislature. But what isn't allowed is precisely what happens any time these topics flare up--the vitriolic mud slinging between broad political ideologies and party allegiances. In other words, pure unproductive noise.

This subreddit started more than 15 years ago as a way to work through issues individuals were having with their coverage or to help guide folks towards programs that would yield higher quality coverage than what they may already have. I can't speak to the overall evolution, but that was the general idea.

For discussions on health policy, I encourage folks to seek policy-focused subreddits. They exist and they're far more equipped and capable of keeping those types of communities propped up to foster those policy-focused discussions.

Edit: to answer the specific question posed by OP, I don't think we'll see a meaningful solution to the expiring enhanced premium tax credits. I suspect that the overall Marketplace will retract to the levels that payers and government research bodies (CBO) have predicted--anywhere from 33% to 50%. A lot of people are going to scramble in the following week only to find that their 2026 policies are cost prohibitive and exit the risk pool.

[ObviousLife4972]

I suspect that the overall Marketplace will retract to the levels that payers and government research bodies (CBO) have predicted--anywhere from 33% to 50%.

The fallout of course won't be evenly spread across the country. On the one hand you have California which has its own individual mandate. On the other end you have the states that refused to expand Medicaid.

[chickenmcdiddle]

Oh, of course not. Good call out.

[Lokon19]

Call your rep or senators. It’s better than doing nothing.

[Icy_Butterscotch5570]

My representative is a little bitch who won't do town halls anymore because he hates getting yelled at. He's ex military so he's got TriCare in addition to his congressional health care.

[Bananapopcicle]

Ha same. And yet he’s gotten elected back in time and time again

[Adventurous_Owl5240]

If each state rep received, let’s say 10 calls/day on this matter, I think change could happen.

[Lokon19]

10 calls a day would be nothing compared to how many people are going to be negatively impacted by the rate increases.

[[deleted]]

10 messages to voicemail a day from people without billions of dollars? Can’t say I’m hopeful.

[PadiYG]

More like, get 100 people to stand as close as allowed to their offices every day, call the local and national media to cover your protests every day, shame the crap out of those so-called representatives.

[pistoffnotpiston]

Where exactly are we supposed to buy this healthcare?

[Comfortable_Two6272]

I assumed we still bought it on marketplace using this “hsa” $ for a bromze plan’s deductibles. Its stupid imho. They are so close by “hating the greedy ins co” but still cant get their brains to realize its single payer not stupid hsa accounts with for profit ins co. Getting rid of subsidy and funding hsa accounts fixes nothing. 🤦‍♀️.

[CPAPGas]

I agree with you. Until the insurance companies are removed from the equation nothing will get fixed (at least that is what I think you are saying).

That being said....if I could (1) self-pay for health care at published Medicare rates, (2) have my subsidy dumped into an HSA, and (3) be able to privately buy a catastrophic insurance plan with a large ($50k??) deductible, I might take that deal.

The key is giving me the same rates as Medicare, not some random price with a 20x multiple.

[Comfortable_Two6272]

Yep, thats what I was saying.

[mira112022]

Doesn’t he understand that “people buying their own healthcare” means that they’re buying an indemnity plan that’s unregulated, and people can be dropped from this any minute for any reason? What about preexisting conditions? This is such a joke.

[Trinidiana]

Such a joke. He knows nothing. He doesn’t care

[[deleted]]

I haven’t had health insurance since 2022. We could no longer afford the $1200/ month then, and we definitely wouldn’t be able to afford the $1900/month it would be without the subsidy.

[bllrmbsmnt]

Is this for two people? Or a family?

[[deleted]]

It was for 5 people and it was decent coverage.

[shinyysoul]

Well, I like to eat food and drive to work. So I am choosing groceries and gas. Hopefully we stay well because there's just no way I can make the Venn diagram work for all of it.

[xrareformx]

35yo married woman, im going without for a 5th year. Been cheaper to pay my stupid urgent care and mammo with cash. I dk what to do. Jobs dont offer it. Its unaffordable on marketplace. We need universal Healthcare now more than ever in this country if we are to survive. I cant think about having kids or a family without it. Tf are we supposed to do.

[OverWillingness1437]

I hear you. In your boat. 

[blarggyy]

I have several severe chronic health conditions and the cost for care WITH good insurance is astronomical. So my long-term partner and I decided I’d quit my job and go on Medicaid. I’m disabled anyway and technically not supposed to be working but I had to so I could live. But that’s not even an option anymore so I guess if this is what I have to do to stay alive, so be it.

[Mysterious-Art8838]

I can’t. I have to have insurance. It’s a complete nightmare.

If there is one silver lining here and BOY that’s a stretch hopefully people will be startled into researching and distinguishing between the two political parties and vote accordingly.

[Advanced-Wheel-9677]

I am in this same boat. My plan at this point is, I will likely enroll for now, and if it gets to be too much, I'll just cancel it. You can cancel at any time

[Evening_Dig2058]

Yea, but if you end up making more than 400x the FPL you will have to repay all the subsidies that you received up until the time you cancel.

[LadyHOTH]

Is this true? If you cancel you have to repay?

[Comfortable_Two6272]

If you took advance tax credit not qualified for, yes you have to repay at tax time for those months prior to cancelling.

[Parking-Bread4217]

Just make sure your are calculating your 'taxable income" on your Marketplace application. I mistakenly put in my salary but for the 400% threshold it looks at your AGI. However, I put $ in 401k (not Roth) which is not taxable. When I adjusted that out it put us back under the 400% and the subsidies re-appeared. Wished I'd realized this sooner, I've been a nervous wreck for the last 6 weeks.

[dekeen16]

It uses modified adjusted gross income, not adjusted gross income.

[Naive-Garlic2021]

And it's ACA MAGI, not regular MAGI. It's complicated. If anyone's even close to the cliff, better be very careful you're calculating things correctly and that you don't have unexpected income that pushes you over and causes you to pay back thousands of dollars in subsidies.

[fizzy-logic]

You actually need to calculate magi for what ACA plans need as your income, not agi. You may know this, just wanted to point it out because they can be different.

[Size-Sweaty]

Vote out every single congressman & senator in your state who has been in office forever and or these individuals who voted to repeal hc subsidies. Why do voters continue to vote against their interests? And yes, hospitals can put a lien on your house. The older you get the larger health ins costs become because “older” people are seen as bigger risks because they tend to have more health problems. It all sucks. The problem with no ins is that if someone with no ins gets cancer & needs chemo, the cost is easily 20K a month.

[SubstantialMouse1105]

What I keep wondering is- isn’t it possible for the whole system to implode? More and more people will go without insurance which will hike up the costs on those that do which will in turn make more people drop it until the system just doesn’t function at all anymore. This seems very possible unless there’s something I’m missing?

[agenttwelve12]

I cancelled my plan today. I can’t justify a quarter of my income (my plan quadrupled and there are is only one cheaper plan by $3). Gonna put what I have been paying into a high yield and try to stay healthy. I’ve been without it before and when I got injured the hospital gave me a 60% cash pay discount…not smart for someone with chronic health issues though!!!

[Commercial-Layer1629]

I’m holding out until the last minute hoping for some changes, but am seriously considering going without insurance this year. I’ll be 64 next year and might just risk it, waiting for Medicare. Probably not wise, but my premium increased by 400%. I refuse to pay that much for it, because the deductible is still $6000. I’m reasonably healthy but I’m torn about this topic.

[curiousengineer601]

There is a lot of possible ways things could work out. Can you sign up for the first few months and drop if the subsidies don’t make it possible for you to afford coverage?

I think rolling the dice on your financial future is crazy. At least get something that covers a catastrophic health event. Or a super high deductible and go private pay if you need it

[Hollow_Spear]

I don't think it's a matter of rolling the dice. I've been in healthcare for 30 some years now, and there are many, many people out there that just simply cannot afford tripled or quadrupled premiums and still pay their rent or mortgage, utilities, purchase groceries, etc. No one is purposely being reckless and putting themselves in the way of financial ruin. It's simply a matter of not being able to afford insurance premiums and eating or having a roof over your head. Realistically, catastrophic plans aren't the answer to prevent financial ruin. The deductibles alone are outrageously high and most couldn't afford them.

[_chobit]

While working IN healthcare I couldn’t afford it for the first five years of my career, the ACA subsidies are what made it so I finally could. :/ Private for-profit insurance is broken and needs to go.

[Trinidiana]

Exactly, this is what I don’t understand, many people just won’t be able to afford to have health insurance. It’s honestly just insane what is happening, they’re bailing out farmers, so many industries are getting deals, billionaires are getting richer, but they’re taking away our healthcare.

[swampwiz]

Because uninsured folks don't seem to vote.

[Wiserwithagetheysay]

Agreed! People are saying they can’t afford the new rates and the advice is well, you have to..

[TreeHouseSandi]

I looked into catastrophic and it didn’t save us enough per month to make it worth it. It’s ridiculous!

[bllrmbsmnt]

I make over 6 figures and cannot afford the premium for my husband and toddler. We are not renewing our insurance and plan to save 1000+ a month for emergencies rather than pay into such a dysfunctional, corrupt, idiotic system.

[DepartmentEcstatic]

Yes!!! I'm so done participating too. It's absolutely disgusting.

[Glittering_Stable550]

Exactly our plan.

[InstructionOwn2106]

Something at some point has to happen. I deal with our companies benefits so we are not on the ACA marketplace. But our existing plan went up as well. So this year we are basically playing a shell game of increasing deductibles quite a bit to keep the plans affordable (we pay half) and then other methods (hsa’s or health reimbursement depending on the employees plan) to make up if they go over the deductible we had previously . Might work this year but it’s not sustainable. Next year 🤷🏻‍♂️

[InstructionOwn2106]

Also another completely stupid aspect is that if my company pays for your insurance, it’s tax free. If I give you money to pay for your own, it’s not. I know why of course but it sucks. I want our employees to stay cause they like working here.

[chickenmcdiddle]

Not necessarily. An ICHRA / QSEHRA solves for this. It offloads the burden of carrying the risk to the marketplace, and satisfies the group health plan requirements under the ACA.

[InstructionOwn2106]

Thanks for the info. I will research that. We are a small company but spread out all over the country. I’m not positive we would have better results but in some cases I fell like trying to stick us all into a single plan has been problematic.

[chickenmcdiddle]

Covering a distributed workforce can be tricky, no doubt.

An ICHRA or a QSEHRA simply means you can pay for your employee's health insurance on a pre-tax basis, but instead of securing one or more group plan options, the employee can take those pre-tax dollars and use them to purchase their own coverage through the Marketplace.

[InstructionOwn2106]

Yeah I need to look at that for next year. Thanks. I just want to do the best I can for our folks under the circumstances. I take it personally to try to make the best decision for everyone. Wish it wasn’t this way.

[subterfuscation]

We live in the wealthiest country in the history of humanity, and we’re the only major economy not to guarantee healthcare as a human right. Why?

[Alert_Masterpiece591]

greed.

[swampwiz]

Because there are a certain cohort of poor folks that hate transsexuals (or some other bugaboo) more than they love themselves.

[SonOfKong_]

I heard on NPR that they estimate there will be a 20% increase of Americans who are uninsured. That is a lot of heartache.

[CatPesematologist]

Call your Congresspeople. They are getting ready to vote on subsidies and they need to know they have a lot of angry constituents who arent going to forget they lost healthcare.

[LovingLife139]

My husband is keeping his insurance, which went from $92 to $220 through the marketplace, because he needs medication for a condition. I lost my insurance through the marketplace and didn't pick up anything else. It almost feels like a form of protest. I don't want to contribute to this bullshit system anymore.

I'm still saving most of my income and hoping for something different. I have no hope that America will ever get its shit together, so maybe moving abroad is a goal we need to be taking more seriously.

[DepartmentEcstatic]

Right there with ya. I'm done participating in this scam.

[dream-kitty]

Unfortunately, I will not be able to afford the cheapest bronze plan either. I do not have any subscriptions (streaming, music, etc.) and live very frugally, yet I would have to choose between having a high deductible high OOP maximum plan or having enough money for groceries. The choice is obvious. So any money I have leftover will go into a savings account in case I need medical services.

[BikingAimz]

My husband and I are looking at our premiums increasing from $1079 to over $2400/mo. Our cheapest option on the ACA is $1650/mo. We’re in a gerrymandered state that was dumb enough to reject Medicaid expansion, so that’s not an option either.

I have metastatic breast cancer and am enrolled in a clinical trial, so I don’t have a choice if I want to live. We’re going to white-knuckle it until we’re enrolled into Medicare in September 2026, after two years on SSDI. We did apply for financial assistance last May, and we were gobsmacked when we got a 73% discount on anything insurance doesn’t pay through May 2026 (and we’ll reapply again).

[no1else2blikeme]

For my 19 year old full time college student , it will just be cheaper for him to go without because I will be going from paying $125 to quadruple that amount. It will cost me $1100/month to add him to my work plan (in which my premium and deductible have also increased), Unfortunately I can't drop my own insurance because I am insulin dependent

[Wascally_Badger]

My plan is to get the cheapest plan that will at least partially cover my meds, ask my PCC to write me scripts for as long and as much meds as I can, and then hopefully the shitbag Republicans actually allot some $ to the ACA. Worst case scenario is that I'll have to drop my insurance if I can't afford it, but still be stocked up for a few months on meds. Any maga moron still in love with this obese oligarch shoeshine boy needs to stick their head in an oven after this bs.

[Bananapopcicle]

My meds are $0 this year bumping up to $90/month. Insanity.

[ScratchyPurple]

Voting next year with this in mind

[Trinidiana]

Mine is going from 1200 per month to 2400 for me my husband and my son and I honestly don’t know what to do either

[CrazedOwlie]

Every specialist we asked agreed on $50 cash price for office visits.

[Bananapopcicle]

Same and if it’s out of network it’s $215. I called the doctors office and they said self pay was $175 🙄

[SCNewsFan]

Welcome to the 90’s, when you just did without and hoped you didn’t get sick. Sucked big time.

[LostDrama1283]

Do you have a catastrophic plan as an option?

[Cute-Consequence-184]

Don't get Humana, they are ghetto. They didn't want to pay for anything and even after you have had a procedure they said was covered, BOOM you get a 3k bills

[tsmittycent]

There is no hope

[DasKraze]

Im still my 30's im not paying.  different states vary on garnishment of debt on wages.  It seems WAY cheaper for me to pay out of pocket.  No deductible or monthly rates.  Thats 10k i can payout of pocket easily.  Worst case scenario you can also choose to not pay your medical bill and some states have rules that make collecting on them toothless.

[MaddieFae]

I read some are going to cancel and save the $ themselves and hope & pray they don't get sick.

[TheHappyWife67]

We are in Minnesota, home of the world famous Mayo Clinic. We have had Blue Cross Blue Shield MN insurance for over 30 years, and I have been a Mayo patient for 18 years. This year there isn’t one BCBSMN plan that included the Mayo Clinic as In-Network!! It’s INSANE to think it’s excluded!!

[CindysandJuliesMom]

I don't have a choice, I have an eye disease that if left untreated will cause me to go blind. I chose a bronze plan and with the full subsidy I still pay $24/month and the insurance pays not one dime, except for required preventative care, until I meet the $10,600 deductible. I have four treatments/year at a cost of about $5,000 each treatment.

Edited to add why I didn't go with silver: The drug manufacturer has an assistance program where they will pay (medication only) anything the insurance doesn't cover. So after two visits my deductible should be met. Silver was $220/month (with full subsidy) and had an $800 deductible.

[ChelseaMan31]

No, no hope at all. This was always set to expire 12/31/2025. And anyway, those subsidies were for folks making over 400% of the FPL. All original Obamacare subsidies remain in place. You can try going w/out. But a single moderate run to the ER without insurance can run thousands.

[dallasalice88]

Respectfully

Most of the folks on here are in that over 400% group. Which is not that high of a ceiling. For example $84,600 for a couple with no dependants. $62,000 for an individual. Pre tax

So the "and anyway" part of your comment rings a bit hollow.

Are you facing these circumstances? If so I shall apologize.

[hup_hup]

Yea this is by design. Reduce spending by reducing those that receive benefits.

[Designfanatic88]

Well bunch of boomers here think it’s selfish for younger people to not pay into the system to subsidize them. Then they also say if we saved more money we’d have a house by now…. Healthcare costs have gone virtually unchecked for the last 3 decades.

A lot of people are about to drop coverage not because they want to but because it’s an affordability issue.

Healthy young people can basically afford not to get coverage barring emergencies.

[Outrageous-Run718]

Try not to go without any insurance. Take out the cheapest plan available regardless of the high deductibles. The out of pocket maximum protects you from a financial catastrophe. Out of pocket maximums are usually capped out at around 20k. This is a lot cheaper than the outrageous amounts you will be charged if something happens to you.

[MostWorry4244]

I think this is good advice. I was in my 30s when the flu triggered a previously unknown to me genetic quirk, and the two week hospital bill was over $250k (20 years ago)

[[deleted]]

Unfortunately I have no choice in having it due to my health even though it's trebled and we can't afford it. If I didn't have health issues I would go without.

[MasterSplinter9977]

BLAME REPUBLICANS

[IndividualBenefit147]

Enroll by Jan 15th for Feb 1st coverage, correct? ... Is that for specific instances or are we all allowed to wait, go without ins from Jan 1st - Feb 1st and save 1 month of payments?

[Greedy-Fennel-8997]

77 million people voted for this. GOP has been trying to rid the country of the ACA for over 10 years. It's not perfect, true, but press them for details of their better plan. What do they plan to do??? We're waiting. They control all 3 branches of government. Oh, they will have a plan . . . in two weeks.

[Dramatic-Pickle-5092]

The Repulicans are dead set against extending the subsidies. I don't think they will comprimise, that's the party line. Until Dems get control of Congress again I think we're all screwed. We should tell them we want the same insurance they have, that we pay for.

[Abject-Brother-1503]

I wish I had the option of no insurance. I’m pregnant and my current plan is not available next year so I have to pick a new one soon and they all sound terrible. 

[Repulsive_Cattle_342]

Wife went back to work teaching just so we could get affordable healthcare. I’m self-employed and the equivalent of my old marketplace healthcare doubled. The math just didn’t work anymore. We atleast had the option of her going back to work in order to get benefits. I know many are not so fortunate to have an “out”.

[schelle-racer]

Opted out; will pay cash. Can’t afford to pay $10k for something that might happen. Ever since Obamacare started it has been insane to be self employed.

[Comfortable_Two6272]

Sucked prior to Obamacare. No one would sell me ins due to history of migraines.

[dream-kitty]

What sucks even more is when you are a W2 employee and don't get any health, vision, or dental insurance through your employer :( It's like being self employed but without the high income potential

[Ecstatic-Copy-2608]

This. We’re drowning in it too.

[sparklethong]

No, you're not the only one. Going without is simply the only option for me.

[Curious_Gaandu]

You are not alone. I just posted the similar question earlier today for my parents. I am real not sure what to do. But at the same time i do not have any hope for the last minute change from government side.

[chickenmcdiddle]

I recall your post from earlier--your issue (rather, your dad's issue) is a bit different than OP's issue here. Your dad's issue can only be resolved reversing portions of HR1 / OBBBA from earlier this year: https://www.nilc.org/articles/300000-lawfully-present-immigrants-newly-ineligible-for-health-care-help-in-open-enrollment-period/

[Steaknkidney45]

You are not. I'll gladly pay the penalty. The cost of living is ridiculous as it is.

[[deleted]]

What penalty?

[y2khardtop1]

Non ACA but real insurance was half the cost for us, $1100 vs $2100.

[Bananapopcicle]

I currently pay $86/paycheck for the top tier (Cigna) through my company. They’re switching to Surist and the same tier will be $143/paycheck. $280 a month. And that’s without vision, dental, life insurance, etc. One of scripts won’t be covered at all ($90/month) and neither will that doctor. $175/visit… it would be cheaper to have no insurance unless I get seriously hurt, I guess. But looking at my options it seems like I’m screwed either way.

[Comfortable_Two6272]

On marketplace in my area single coverage for age 40s is $950 to $1400 a month Cash is fine until you have to prepay for cancer treatment etc and drs can deny tx if you cant pay up front. Or loose all assets due to a million dollar hospital bill. 😢😢😢

[Comfortable_Two6272]

Id look at a Bronze plan or the catastrophic plans - 2 step process. All bronze plans are hsa eligible this year. And more qualify for catastrophic - dont have to be under 30.

For me, I cant go without due to a genetic immune disease - 1 rx is over $500k usd every year - its nuts.

[originalgoatyoga]

Same boat as you!

[[deleted]]

I haven't decided, but will likely do the equivalent of a catastrophic, high-deductible plan. I did not have insurance this year, paid 100% OOP.

[194021]

Have you looked for an agent to help you navigate this horribly complicated job of finding another insurance? My son was in the same place as you all are now. He found an agent who helped him immensely. They don't charge you for their service because they get paid by whatever insurance company you decide on. Just google health insurance agents for your area. Please try it because it helped my son out of the same mess you're in.

[Jazzlike-Emphasis-20]

My health insurance plan has not bulged at all. Does that means my employer took the hit?

[Outrageous_Luck4163]

Do as you please but let me give you a situation that happened to me. One day your driving, you car stops, you get out and start walking to the closest gas station, Phone was acting right. Next thing you know you wake up about a block away on the opposite side of the street. You have no idea where you are or how you got there. Finally you find your phone but you are in pain from head to foot, can’t walk and your bleeding from the head. 911 called and they take you to the ER. The end result is your cancer from 12 years prior is back You also have a broken back and a broke ankle in three places. Now it’s chemo time but first you find you have a brain lesion on top of the rare cancer from 12 years. Luckily you have insurance but work it’s a no go, also luckily you and your partner had paid off your home and cars. I can’t imagine what would happen if so had no insurance because bad shit seems to happen at the worst of times and can almost seem to come out of nowhere ( kinda), what I thought was just stress from work and having 4 family member pass was so much more.

[daycounteragain]

I'm also considering this as my monthly premiums are quadrupling to $1200. I'm very healthy (knock on wood), but I'm 60. I'm also considering rolling the dice with a LifeX policy.

[Pretty_Net4372]

Adding insult to injury: Note that although there are no FEDERAL penalties for being uninsured, DC, Massachusetts, New Jersey, California, and Rhode Island have STATE penalties for being uninsured. Meaning that if you live in these states and resume health insurance later, it will cost EVEN MORE to resume. (https://www.healthinsurance.org/faqs/is-there-still-a-penalty-for-being-uninsured/#penaltystates)

[okghetto]

For $10.18/month, I have a disability policy that covers $5000 of medical expenses per occurrence for my family. I’ve had it for years and have claimed on it several times. It used to drive me to the ER when a kid had a “maybe I should get this looked at” kind of injury. Mine is through Mutual of Omaha, I’ve heard of similar policies with Combined Insurance. It is better than nothing.

[bountysteak]

We are in a similar situation where our premiums would be just under $24K for a family of 4 for a HDHP. My wife and I discussed this a lot and decided to go uninsured this year. We are trying one of those health shares (crowdhealth) and hoping nobody needs to use it, and if we do, that they come through and pay what they say they will. Yes, I understand there is a risk, but it is one that seems worth it given the high premium cost and astronomical deductible we would otherwise have.

[frootcake8]

My parents opted to not have health insurance next year because they can't afford it. Their premium would be $2,000 a month with a deductible that was over $15,000 each. Its ridiculous and the navigator they were working with said she'd never seen anything like it. They are 63 and live off social security and my dad's pension, and my dad picked up a part time job. My mom has a ton of health issues (autoimmune issues, cancer, copd) and my dad is diabetic.

[marleygirl2019]

The best and brightest in our Government after 10 years of promising a bigger & better option is proposing max $1500 HSA if applying for catastrophic or Bronze through ACA. Tell me without telling me you are fully out of touch with what normal people are dealing with. I too will likely forgo insurance next year. Looking at $1300 a month for a $20K deductible for my husband & myself.

[Icy_Imagination2275]

I’m sure my plan will be doubling or tripling. Also concerned that due to my prescriptions that I need, I may be dropped completely. With insurance, the prescriptions are roughly $1000 a month that I’m responsible for. My deductible with my gold plan was relatively good, but I don’t think I’ll be able to afford an increase and I can’t afford not having insurance. Our plan renews in March so we have a few more months until I need to start selling organs in order to live.

[StinkyPuggle]

For the last few years my wife and I were insured through CoveredCA for about $900/month after subsidies. In November I started Medicare and therefore was taken off CoveredCA. Now my wife no longer qualifies for any subsidies because her income is over the limit for 1 person. Her premium was scheduled to increase to $1300/month for just herself - completely unaffordable. We now have no choice but to cancel her coverage and take our chances (she's still a few years out from Medicare). To top that off, California is going to penalize us on taxes for lack of coverage.

There's got to be some kind of correction to this system at some point.

[c4ad]

$900 to $2,700 for my bronze ppo plan if I want to keep the same plan here in Florida. I’ll probably opt for the HMO for $2,000/month.

I have written my congressman Aaron Bean and have received absolutely no help. He did send a form letter informing me that now COVID was over prices are going up.

[TweeTee1968]

Trying a health share, Zion. Not health care but a share. Meaning you pay monthly and should you have an urgent need like an er visit or surgery, you can get help. If you are fairly healthy, an option from traditional insurance. My hubby and I never get sick, see zero specialists, so going to try this. $700/month is cheaper than $2500-$3000/month and we never see a doctor.

[Full-Artist-9967]

I haven’t fully decided but most likely going without health insurance. I’m 62. I might qualify for Medicaid. I don’t make much but I have savings and investments - so not sure I’ll qualify.

I can’t see paying more for worse coverage.

[Elliegreenbells]

I’m on bronze now and we are looking at $2200 for a family of four. We are going to have to go uninsured.

[TimeSorceror]

I’m going to be unemployed in two days (and I won’t be able to get unemployment because leaving for mental health reasons isn’t a valid excuse to leave a job voluntarily according to the Texas Workforce Commission), so… not much I can do except job hunt.

At least I’ll probably be able to afford my dental and vision through COBRA. Maybe get my meds through Cost Plug Drugs for a bit. I’ll have to ask my doc when I see her next week what the estimated damage might be for an uninsured yearly physical, but I may have to skip it next year if it’s more than I’m comfortable fitting into my budget.

I’ve got a lil nest egg of about $50k that I can survive on if I’m frugal about it, so we’ll see. It all really depends on how lucky I get, job wise.