(Maria Fabrizio for WPLN and KFF Health News)<\/p>\n
Not many 22-year-olds share DJ Mikunda\u2019s enthusiasm for health insurance coverage.<\/p>\n
\u201cYou know what sounds like a good Friday night? It\u2019s looking at health insurance,\u201d he joked.<\/p>\n
But Mikunda has a reason to be eager. He has gone without coverage since he left home and started working in 2023. He\u2019s now a manager at a gas station in St. Louis.<\/p>\n
In years past, he has looked at plans on the health insurance marketplace at healthcare.gov<\/a> \u2014 but the options proved overwhelming and a bit too expensive.<\/p>\n \u201cI feel like I\u2019m a well-informed individual,\u201d Mikunda said. \u201cI try to stay updated on what a deductible is and what the premiums are and copays. And I\u2019m still finding myself a little bit lost.\u201d<\/p>\n To sort through the basics, HealthQ introduced Mikunda to independent assister Jackie Shrago<\/a>, who has been helping people navigate the insurance marketplace since the early days of the Affordable Care Act.<\/p>\n The QTip:<\/strong><\/p>\n Search for a free \u201cindependent assister\u201d on healthcare.gov<\/a> to better understand your insurance options.<\/p>\n Income Drives the Conversation<\/strong><\/p>\n Shrago started by asking Mikunda about his income. How much money you expect to make in the coming year determines whether you\u2019re eligible for reduced monthly payments. The system uses a sliding scale for households making less than 400% of the federal poverty rate<\/a> \u2014 which means, for 2027 enrollees, an individual with no children can make up to $63,480 and still qualify for a discount.<\/p>\n A person in their mid-20s making $50,000, for instance, would get an average 23% discount, according to KFF\u2019s subsidy calculator<\/a>. For someone making $30,000, the tax credit would cover nearly three-quarters of the cost.<\/p>\n It\u2019s important to estimate next year\u2019s income as accurately as possible. If you end up making more than anticipated, you may owe money back to the government.<\/p>\n \u201cThe last thing you want is a surprise when you file your income taxes,\u201d Shrago told Mikunda.<\/p>\n Short-Term Affordability vs. Long-Term Needs<\/strong><\/p>\n Then, Shrago pivoted to the other considerations: How much can you afford to pay every month? And what kind of coverage do you really need?<\/p>\n It\u2019s a personal decision about financial planning and risk tolerance, balancing up-front payments with out-of-pocket costs. Mikunda knows he\u2019ll need regular doctor visits and prescription medication, because he has a chronic joint condition that has gone virtually untreated since he started working and lost Medicaid coverage.<\/p>\n So he might consider stretching his monthly budget for a plan that covers more of the medical cost.<\/p>\n Those financial trade-offs drive much of the decision, forcing you to find a \u201ccomfortable medium\u201d between the level of coverage you want and the amount you\u2019re willing to pay, Mikunda said.<\/p>\n Gather Your Decision Team<\/strong><\/p>\n There\u2019s much to consider, especially for a first-timer. But one-on-one help is available at healthcare.gov<\/a>.<\/p>\n If you click on the link to \u201cFind local help<\/a>,\u201d you can filter specifically to search for \u201cindependent assisters\u201d like Shrago in your ZIP code. Unlike insurance agents and brokers, assisters are forbidden from charging for their services or receiving compensation from insurance companies. (The brokers listed at healthcare.gov far outnumber the independent assisters, but the assisters are findable.)<\/p>\n Shrago also recommends starting the selection process early enough to step away and think.<\/p>\n \u201cIf you\u2019re dealing with something that is uncertain enough and you feel really awkward about it, you don\u2019t need to make a decision today,\u201d she said. \u201cTake your time and think about it.\u201d<\/p>\n Assisters tend to have the least availability right before the federal marketplace\u2019s Jan. 15 deadline, so reach out early.<\/p>\n People and Policy<\/strong><\/p>\n The Trump administration cut funding for independent assisters and navigator nonprofits by roughly 90%<\/a> in 2025. When making that announcement, the Centers for Medicare & Medicaid Services said the program was inefficient<\/a>, costing more than $1,000 per person enrolled. The reduction in funding means fewer people helping. In Ohio, for example, the number of paid navigators serving state residents dropped from 50 to five<\/a> at the start of open enrollment in 2025.<\/p>\n Katherine Ruppelt and<\/em> Emily Siner at Nashville Public Radio contributed to this report.<\/em><\/p>\n HealthQ is a health series from reporters Cara Anthony and Blake Farmer, approachable guides to an unapproachable healthcare system. It\u2019s a collaboration between Nashville Public Radio and KFF Health News.<\/em><\/p>\n<\/div>\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>.<\/em><\/p>\n This article<\/a> first appeared on KFF Health News<\/a> and is republished here under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License<\/a>.<\/p>","protected":false},"excerpt":{"rendered":" (Maria Fabrizio for WPLN and KFF Health News) Not many 22-year-olds share DJ Mikunda\u2019s enthusiasm for health insurance coverage. \u201cYou know what sounds like a good Friday night? It\u2019s looking at health insurance,\u201d he joked. But Mikunda has a reason to be eager. He has gone without coverage since he left home and started working…<\/p>\n","protected":false},"author":0,"featured_media":16631,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-16630","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\/16630"}],"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=16630"}],"version-history":[{"count":0,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/16630\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/media\/16631"}],"wp:attachment":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=16630"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=16630"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=16630"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}