January 1 is the date on which additional financial assistance for purchasing health insurance under the Affordable Care Act ends.
AND MARTINEZ, GUEST:
Health insurance is much more expensive this year for the millions of Americans who purchase coverage under the Affordable Care Act.
MICHEL MARTIN, HOST:
Many people receive government subsidies to help pay their monthly premiums for this insurance. During the COVID pandemic, Congress created additional subsidies to make coverage affordable. But those extra subsidies expired last night, leaving consumers with difficult choices. On average, premiums for these market plans are more than double what they were in 2025. We'll be talking soon with Democratic Senator Peter Welch of Vermont about where bipartisan negotiations stand on the future of insurance premiums. But first, let's get the facts.
MARTINEZ: Health reporter Sarah Boden joins us to discuss what's next. So, Sarah, higher dues – what does enrollment look like now?
SARAH BODEN: Yes, preliminary data for December shows that enrollment is down slightly compared to December last year, but overall it is higher than expected. I spoke with Cynthia Cox of the health policy think tank KFF, and she says we all need to realize that these numbers are likely to change.
CYNTHIA COX: It's kind of the difference between putting items in your cart and actually buying them. So you don't actually own these products until you pay for them. It's the same with health insurance. Like, you can subscribe. You can choose a plan. But until you pay for it, it's not your health insurance plan.
BODEN: So she's keeping an eye on how many people keep their coverage. And many people have been automatically re-enrolled into the same policy but now have a higher premium, but they may not know it yet. So, we're in for a sticker shock. An estimated 4.8 million people will give up insurance because they can't pay for it.
MARTINEZ: Yes. And health care costs are a big political issue right now. I mean, after all, it's an election year. I mean, is there any chance that this could change?
BODEN: You know, there is a discussion between Democrats and moderate Republicans about extending the subsidies. And if they did, they could make them retroactive. But many Republicans won't vote for him without getting anything in return. For example, Republicans have suggested that people open health savings accounts to set aside funds for emergencies. Others said they potentially support extending subsidies in exchange for new restrictions on abortion. But these ideas didn't get very far at all. And even if the compromise had passed the House, the Senate would have been tougher.
MARTINEZ: Yes. You know, Sarah, looking at the numbers, 24 million Americans implement their plans through the market. I mean, what are their options if they can't afford the new premium but don't want to remain uninsured?
BODEN: The first step, if you haven't already, is to go and see exactly how much you're willing to pay this year, because if you don't like that number, you probably still have time to change your policy. In most states, the deadline to sign up for a 2026 plan is January 15th. This coverage will begin in February. And I've talked to people who have chosen plans with lower premiums but higher out-of-pocket costs, such as a $7,000 or $8,000 deductible.
MARTINEZ: Oh, man, that's very oh. This will hurt.
BODEN: It's a lot of money, but it may be a viable option for people who are healthy and don't go to the doctor very often. It's a risky game.
MARTINEZ: Yes, absolutely. This is health reporter Sarah Boden. Sarah, thank you so much for joining us.
BODEN: Thanks for having me.
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