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Millions of Americans face a looming health insurance crisis as COVID-era subsidies near expiration, forcing families to make difficult financial choices in the weeks ahead. With less than three weeks until enhanced tax credits expire, individuals across the country are preparing for dramatically higher insurance costs in 2026.
The Senate recently rejected two proposals to address the issue, and House Republicans’ emerging healthcare package does not include an extension of these vital subsidies, which have helped millions afford their Affordable Care Act (ACA) coverage for the past four years.
In rural Wisconsin, retirees Chad and Kelley Bruns exemplify the harsh reality many Americans face. The couple, known for their frugality, is being forced to downgrade their insurance coverage significantly. Currently paying just $2 monthly for a gold-level plan with a reasonable $4,000 deductible, they face a staggering increase to $1,600 per month for the same coverage in 2026.
“We have to pray that we don’t have to have surgery or don’t have to have some medical procedure done that we’re not aware of,” said Kelley Bruns. “It would be very devastating.”
The couple has opted for a bronze-level plan instead, which will cost about $25 monthly but comes with a $15,000 deductible and a $21,000 out-of-pocket maximum—nearly half their joint annual income. This dramatic reduction in coverage quality while still facing potentially catastrophic costs illustrates the precarious position many low-income and retired Americans find themselves in.
For some families, the situation is forcing even more drastic decisions. Dave and Kristin Roof of Grand Blanc, Michigan, have relied on ACA insurance since the program’s inception in 2014. The availability of affordable marketplace insurance gave Dave the confidence to start his own music production company, while Kristin built a successful business on Etsy.
With a joint income of approximately $75,000, the Roofs have managed to cover their $500 monthly premium. However, with subsidies expiring, they face a minimum $700 monthly payment alongside higher deductibles and out-of-pocket expenses. The increase has forced them to make an alarming decision: going without health insurance entirely in 2026.
“The fear and anxiety that it’s going to put on my wife and I is really hard to measure,” Roof explained. “But we can’t pay for what we can’t pay for.”
Single parents are particularly vulnerable to these changes. Katelin Provost, a 37-year-old social worker and single mother from Henderson, Nevada, describes the middle class as experiencing “full suffocation” rather than just a squeeze. Already maintaining a strict budget for housing, groceries, and childcare for her four-year-old daughter, Provost faces a premium increase from $85 to nearly $750 monthly.
She plans to pay the higher rate in January while hoping for congressional action, but acknowledges she’ll likely have to drop her own coverage and maintain insurance only for her daughter if the subsidies aren’t extended. Even affording one month at the higher rate means making immediate sacrifices. “Christmas will be much smaller,” Provost noted.
The expiration of these subsidies represents one of the most significant threats to healthcare affordability since the ACA’s implementation. The enhanced credits, introduced during the COVID-19 pandemic, eliminated the income cap for subsidy eligibility and increased assistance for those already qualifying, making insurance more affordable for millions of Americans.
Healthcare policy experts warn that allowing these subsidies to expire could trigger a domino effect in the insurance marketplace. As healthier individuals drop coverage due to affordability concerns, the remaining insurance pool becomes sicker on average, potentially leading to even higher premiums in subsequent years.
With congressional action looking increasingly unlikely before year-end, millions of Americans face difficult choices between maintaining health coverage and meeting other essential expenses in 2026, highlighting the persistent challenges in America’s healthcare system despite advances made under the ACA.
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14 Comments
This news highlights the ongoing challenges with healthcare affordability in the US. While the ACA has made progress, the potential expiration of these subsidies is a worrying development that requires immediate attention from policymakers.
It’s troubling to see the challenges facing individuals like the Bruns as they are forced to downgrade their coverage due to rising costs. This highlights the ongoing struggles with healthcare affordability in the US.
Absolutely, the Bruns’ situation is a sobering example of the real-world consequences of losing these vital subsidies. Families should not have to choose between basic healthcare and financial security.
The potential loss of these vital subsidies is a concerning issue that will have far-reaching consequences for Americans’ access to affordable healthcare. Policymakers must prioritize finding a solution to this looming crisis.
This is a concerning issue that will have a significant impact on many Americans. The ACA subsidies have been crucial in making healthcare more accessible and affordable. Losing this support will be a major financial burden for families.
It’s disheartening to see the difficult choices that individuals like the Bruns are being forced to make due to the rising costs of healthcare. This is a problem that needs urgent attention and resolution.
This news highlights the ongoing challenges with the US healthcare system. While the ACA has made progress, there is still much work to be done to ensure everyone has access to quality, affordable care.
The Senate’s rejection of proposals to address this issue is disappointing. Policymakers need to find solutions to ensure healthcare remains accessible and affordable for all Americans, especially those most vulnerable.
Agreed. With the ACA subsidies set to expire soon, Congress must act quickly to prevent millions from facing significantly higher insurance costs that could price them out of necessary coverage.
The expiration of these subsidies is a troubling development that will undoubtedly cause financial hardship for many families. Policymakers must act quickly to find a solution that protects vulnerable Americans.
The situation facing the Bruns and others like them is truly worrying. Healthcare costs should not force families to make such difficult financial choices or compromise on their coverage.
This is a complex issue with significant implications for millions of Americans. Ensuring access to affordable healthcare should be a top priority for policymakers as they work to address this looming crisis.
It’s concerning to see the potential for a health insurance crisis as these subsidies expire. Policymakers must find a way to protect vulnerable Americans from being priced out of essential healthcare.
Absolutely. With the costs of healthcare continuing to rise, the loss of these subsidies could have devastating consequences for many families across the country.