{"id":10809,"date":"2026-01-16T10:00:00","date_gmt":"2026-01-16T10:00:00","guid":{"rendered":"https:\/\/medical-article.com\/?p=10809"},"modified":"2026-01-16T10:00:00","modified_gmt":"2026-01-16T10:00:00","slug":"as-insurance-prices-rise-families-puzzle-over-options","status":"publish","type":"post","link":"https:\/\/medical-article.com\/?p=10809","title":{"rendered":"As Insurance Prices Rise, Families Puzzle Over Options"},"content":{"rendered":"

New York-based performer Cynthia Freeman<\/a>, 61, has been trying to figure out how to keep the Affordable Care Act health plan that she and her husband depend on.<\/p>\n

\u201cIf we didn\u2019t have health issues, I\u2019d just go back to where I was in my 40s and not have health insurance,\u201d she said, \u201cbut we\u2019re not in that position now.\u201d<\/p>\n

Freeman and her husband, Brad Lawrence<\/a>, are freelancers who work in storytelling and podcasting.<\/p>\n

In October, Lawrence, 52, got very sick, very fast.<\/p>\n

\u201cI knew I was in trouble,\u201d he said. \u201cI went into the emergency room, and I walked over to the desk, and I said, \u2018Hi, I\u2019ve gained 25 pounds in five days and I\u2019m having trouble breathing and my chest hurts.\u2019 And they stopped blinking.\u201d<\/p>\n

Doctors diagnosed him with kidney disease, and he was hospitalized for four days.<\/p>\n

Now Lawrence has to take medication with an average cost<\/a> without insurance of $760 a month.<\/p>\n

In January, the cost of the couple\u2019s current \u201csilver\u201d plan rose nearly 75%, to $801 a month.<\/p>\n

To bring in extra cash, Freeman has picked up a part-time bartending gig.<\/p>\n

Millions of middle-class Americans<\/a> who have ACA health plans are facing soaring premium payments in 2026, without help from the enhanced subsidies that Congress failed to renew. Some are contemplating big life changes to deal with new rates that kicked in on Jan. 1.<\/p>\n

It often falls to women to figure out a family\u2019s insurance puzzle.<\/p>\n

Women generally use more health care<\/a> than men, in part because of their need for reproductive services, according to Elizabeth Tobin-Tyler<\/a>, a professor at Brown University\u2019s School of Public Health.<\/p>\n

Women also tend to be the medical decision-makers<\/a> for the family, she said, especially for the children.<\/p>\n

\u201cThere\u2019s a disproportionate role that women play in families around what we think of as the mental load,\u201d said Tobin-Tyler, and that includes \u201cmaking decisions around health insurance.\u201d<\/p>\n

Before the holidays, Congress considered<\/a> a few forms of relief for the premium hikes, but nothing has materialized, and significant deadlines have already passed.<\/p>\n

Going Uninsured?<\/strong><\/p>\n

As the clock ticked down on 2025, B. agonized over her family\u2019s insurance options. She was looking for a full-time job with benefits, because the premium prices she was seeing for 2026 ACA plans were alarming.<\/p>\n

In the meantime, she decided, she and her husband would drop coverage and insure only the kids. But it would be risky.<\/p>\n

\u201cMy husband works with major tools all day,\u201d she said, \u201cso it feels like rolling the dice.\u201d<\/p>\n

NPR and KFF Health News are identifying B. by her middle initial because she believes her insurance needs could affect her ongoing search for a job with health benefits.<\/p>\n

The family lives in Providence, Rhode Island. Her husband is a self-employed woodworker, and she worked full-time as a nonprofit manager before she lost her job last spring.<\/p>\n

After she lost her job, she turned to the ACA marketplace. The family\u2019s \u201cgold\u201d plan<\/a> cost them nearly $2,000 a month in premiums.<\/p>\n

It was a lot, and they dug into retirement savings to pay for it while B. kept looking for a new position.<\/p>\n

Because Congress failed to extend enhanced subsidies for ACA plans, despite ongoing political battles and a lengthy government shutdown over the issue, B.\u2019s family plan would have cost even more in 2026 \u2014 almost $3,000 a month.<\/p>\n

\u201cI don\u2019t have an additional $900 lying around in my family budget to pay for this,\u201d she said.<\/p>\n

B. had already pulled $12,000 out of retirement funds to pay her family\u2019s 2025 rates.<\/p>\n

Unless she finds a new job soon, the family\u2019s projected income for 2026 will be less than 266% of the federal poverty level<\/a>. That means the children qualify for free coverage through Medicaid.<\/p>\n

So B. decided to buy a plan on the ACA marketplace for herself and her husband, paying premiums of $1,200 a month.<\/p>\n

\u201cThe bottom line is none of this is affordable,\u201d she said, \u201cso we\u2019re going to be dipping into savings to pay for this.\u201d<\/p>\n

Postponing a Wedding<\/strong><\/p>\n

The prospect of soaring insurance premiums put a pause on Nicole Benisch\u2019s plans to get married.<\/p>\n

Benisch, 45, owns a holistic wellness business in Providence. She paid $108 a month for a zero-deductible \u201csilver\u201d plan on Rhode Island\u2019s insurance exchange.<\/p>\n

But the cost in 2026 more than doubled, to $220 a month.<\/p>\n

She and her fiance had planned to marry on Dec. 19, her late mother\u2019s birthday. \u201cAnd then,\u201d she said, \u201cwe realized how drastically that was going to change the cost of my premium.\u201d<\/p>\n

As a married couple, their combined income would exceed 400% of the federal poverty level and make Benisch ineligible for financial help. Her current plan\u2019s monthly premium payments would triple, costing her more than $700 a month.<\/p>\n

Benisch considered a less expensive \u201cbronze\u201d plan, but it wouldn\u2019t cover vocal therapy, which she needs to treat muscle tension dysphonia<\/a>, a condition that can make her voice strain or give out.<\/p>\n

If they get married, there\u2019s another option: Switch to her fiance\u2019s health plan in Massachusetts. But that would mean losing all her Rhode Island doctors, who would be out-of-network.<\/p>\n

\u201cWe have some tough decisions to make,\u201d she said, \u201cand none of the options are really great for us.\u201d<\/p>\n

This article is from a partnership with <\/em>NPR<\/em><\/a>.<\/em><\/p>\n

KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\n

USE OUR CONTENT<\/h3>\n

This story can be republished for free (details<\/a>).<\/p>","protected":false},"excerpt":{"rendered":"

New York-based performer Cynthia Freeman, 61, has been trying to figure out how to keep the Affordable Care Act health plan that she and her husband depend on. \u201cIf we didn\u2019t have health issues, I\u2019d just go back to where I was in my 40s and not have health insurance,\u201d she said, \u201cbut we\u2019re not…<\/p>\n","protected":false},"author":0,"featured_media":10810,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-10809","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articles"],"_links":{"self":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/10809"}],"collection":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=10809"}],"version-history":[{"count":0,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/10809\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/media\/10810"}],"wp:attachment":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=10809"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=10809"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=10809"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}