(NEW YORK) — Stacy Cox used one word repeatedly as she described how she felt after learning her ACA premium could jump over 300% without the enhanced tax credits: “devastating.”
“I don’t know if I’ve ever cried opening a letter from an insurance or before, but it happened this time,” she told ABC News.
Cox’s premium this year has been $495.32 for coverage for her and her husband. Without the credit in 2026, she was informed that it’s increasing to $2,168.68.
“It’s devastating because we can’t afford that,” she said. “Just that bill right there, that’s more than our mortgage, our insurance, most of our food. That’s what we’re paying per month to live. We can’t afford to double what it costs for us to live just to have health insurance.”
“This will devastate us if we tried to pay it,” she added.
Millions across the country are discovering just how much their plans will cost as open enrollment for Affordable Care Act insurance plans began on Nov. 1. Enrollment lasts through Jan. 15, 2026.
A recent analysis from KFF found that if the enhanced premium tax credits expire, as they are currently set to do on Dec. 31, ACA enrollees will see their monthly premiums more than double – rising by roughly 114% on average. An estimated 22 million out of 24 million ACA marketplace enrollees are currently receiving a tax credit to lower their monthly premiums. Even if those credits are extended, KFF found that the amount insurers charge for ACA premiums will rise by an average 26% in 2026.
The current government shutdown has hinged on Democrats and Republicans’ positions on ACA subsidies, or premium tax credits, which help lower or eliminate the out-of-pocket cost of monthly premiums for those who purchase insurance through the health insurance marketplace.
The subsidies are currently set to expire at the end of 2025. Democrats have been demanding Republicans pass extensions of the subsidies before the government is reopened, while the GOP says it won’t negotiate until a clean funding bill passes and the government reopens.
For Cox and her husband, who live in Kanab, Utah, even if the tax credit were to be extended, they’d still see the premium increase to $753.68. It would be a hit to their budget, but one they would take to keep insurance.
“It’s already going to be hard for us to have a 52% increase on our premium, and that’s if the credits are extended,” she said. “But we will do it so that we can have health coverage.”
Cox, 48, is at high risk for breast cancer, has a mammogram every year and a fast breast MRI yearly as well.
Cox is a professional photographer and she and her husband, 55, have been enrolled in “Obamacare” since 2022. Having access to health care through the ACA is what gave her the motivation to quit her previous job and pursue her passion of photography, she said.
For now, she’s holding on to hope that the tax credits are extended and will reenroll in her plan so she doesn’t miss open enrollment. But she is ready to cancel it before the start of the new year if they aren’t.
ACA enrollee left feeling ‘helpless’ after seeing premium quadruple
Beth Dryer is realizing she is in a similar position. If the tax credit isn’t extended, she says she will have no other option than to cancel it altogether.
Dryer, from Norfolk, Virginia, is the executive director of 757 Creative ReUse Center, a nonprofit art supply store, and in 2015 she was paying just shy of $80 for her premium.
She hadn’t looked up her 2026 options until speaking to ABC News on Thursday, and the spike was shocking.
“This says I now have an advanced premium tax credit of $0 so it looks like I have no tax credit for this so far for next year,” she said, reading from the enrollment site. “OK, so it looks like the same plan that I have this year would now be $425.03 a month next year, which is completely out of my budget.”
“I thought maybe it would double, but this is more than quadrupled in cost for me,” she continued. “So it’s just straight out — there’s no way I would be able to afford this next year.”
Dryer, a Democrat, said she realizes lawmakers are “stuck between a rock and a hard place,” but her message to them is to “get your stuff together and look at what you’re doing to the people of this country.”
“The Republicans aren’t going to budge on the tax credits, and they’re happy to watch people die. I mean, that’s essentially what it is,” she said. “You cut these tax credits, people are dying. People are already dying because they don’t have quality health care. People are already dying because they have food insecurity.”
Covering costs on their own
Cox said she and her husband will have to start their own savings account for medical costs if they cancel.
“We will just create our own health savings, which is we were able to cover $500 per month for our health premium and so we will take $500 and we will put it into savings every month, so that if something does occur, when we do need to go to the doctor, that there’s at least something, some sort of cushion, as we try to cover this on our own,” she said.
Cox said although the health system may not be great, “it’s actually a functioning system” that allows her family to at least have a health plan.
With these tax credits being a sticking point in this shutdown, Cox wants Congress to “extend the credits while you work on reform.”
“This system can absolutely be improved … but don’t make us suffer while you figure it out. That’s what I would say. Don’t make me live without health insurance, while you guys figure out a better plan,” she said. “We have a plan that’s not the greatest plan, but it is a functioning plan. Let us rely on this functioning plan until there is something better. Don’t take my house from me, just because you say you’re building me a new one.”
And she’d also tell lawmakers: “You have health care. Why not extend that to me?”
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