Adrienne Martin and her family are entering the New Year without healthcare coverage.
The 47-year-old Texas resident faced a difficult decision when her monthly healthcare premium was set to increase from a manageable $630 to an unaffordable $2,400 in 2026.
Her husband requires an IV medication for a blood-clotting disease, which costs $70,000 monthly without insurance. Anticipating the lapse in benefits, the family stockpiled the medication to bridge the initial months of the year.
“It would be equivalent to paying two mortgage payments,” she stated, regarding the new monthly healthcare expense. “We simply cannot afford $30,000 annually for insurance.”
Ms. Martin’s family is not alone in this predicament. Millions of Americans face the prospect of soaring healthcare costs as subsidies provided under the Affordable Care Act (ACA), commonly known as Obamacare, are set to expire.
While bipartisan efforts in Congress sought to extend these subsidies into 2026, legislative gridlock in Washington has stalled progress. A vote in the new year offers a glimmer of hope, but until then, numerous individuals like Ms. Martin will either go without insurance or face substantial increases in their premiums.
Approximately 24 million Americans obtain health insurance through the ACA marketplace, with the majority benefiting from tax credits to reduce monthly costs.
These tax credits, also known as subsidies, were initially established under former President Barack Obama’s ACA in 2014 and subsequently expanded during the COVID-19 pandemic.
The battle to extend these subsidies became central to the longest government shutdown in US history, lasting over 40 days earlier this year.
Democrats sought to compel Republicans to extend the subsidies for an additional three years, at a cost of $35 billion per year. Republicans, however, opposed further government funding of the subsidies without accompanying spending cuts.
The weeks-long shutdown – which disrupted essential government services for millions – concluded when a group of Democratic senators agreed to reopen the government, contingent upon a Senate vote on extending the subsidies.
Despite efforts from both Democrats and four Republicans to bring the issue before Congress prior to the expiration of the subsidies, a vote has yet to occur.
“I am furious on behalf of the American people,” stated New York Congressman Mike Lawler, a Republican who advocated for the subsidies. “Everyone has a responsibility to serve their district, to their constituents. Ironically, three-quarters of people on Obamacare reside in states won by Donald Trump.”
Without the subsidies, the monthly cost of healthcare could surge by an average of 114%, according to the health research non-profit KFF.
Maddie Bannister is among those bracing for this reality.
The California mother, who recently welcomed her second child, was paying $124 per month for her family of three in 2025. With the arrival of a new baby and the absence of ACA subsidies, she is now preparing to pay $908 per month.
“Many people will opt to remain uninsured because it is more affordable to pay a penalty for being uninsured than it is to have healthcare,” she said.
For Ms. Bannister’s family, the rising cost of healthcare necessitates delaying other expenditures: “We were saving for a home, and saving money for that will take considerably longer if we have to spend $11,000 annually on healthcare that we rarely use.”
While Ms. Bannister is grappling with her new bill and Ms. Martin is forgoing healthcare, others are turning to alternative government programs to secure coverage.
For years, Stephanie Petersen relied on Medicaid – a healthcare program for lower-income Americans – for coverage. She recently transitioned to the ACA, a welcome change for the 38-year-old.
However, with her healthcare costs soaring from $75 to $580 per month, she is reverting to Medicaid coverage in the New Year.
“I am trying to remain optimistic, but given the current trajectory, I am not hopeful,” the Illinois resident stated. “Everyone should have access to affordable, quality healthcare, without having to navigate these bureaucratic hurdles.”
A vote on the three-year extension of the ACA subsidies is now anticipated during the week of January 5, when Congress reconvenes in Washington.
Until then, Ms. Martin will be among the more than 27 million Americans without health insurance in 2026.
Experts warn that this number is likely to increase as healthcare costs continue to rise.
“We are not low-income; we earn a respectable income, but we cannot afford $30,000 annually for insurance. It’s absurd,” she said.
“We have done everything we were supposed to do, worked our entire lives, worked diligently, and we are simply getting penalized. The entire system is a nightmare.”
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