OMAHA, Neb. (KMTV) — The December 15 deadline for enrollment in the Affordable Care Act if approaching and if Congress doesn't renew the enhanced subsidies, many neighbors don't know how they're going to afford health insurance next year.
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Wendy Evans, who works for a small business that doesn't provide health insurance, has been shopping on the ACA marketplace. Without the subsidies, she doesn't think she can afford health insurance next year.
"It's definitely, definitely disappointing, disheartening, and very, very frustrating," Evans said, sitting in the dining room of her Florence home.
The enhanced health insurance subsidies, passed by Congress during the COVID pandemic, will expire this year unless Congress takes more action. That means, a $10,000 deductible plan could cost Evans roughly $1,000 a month instead of approximately $200.
"There's just like, no way I could do that. So, that's about a third of my income," Evans said.
Financial advisor and insurance broker Chip Monahan is trying to help his clients before the enrollment deadline. He's seeing dramatic cost increases.
"The Affordable Care Act and it's not so affordable anymore," Monahan said.
One family of six was paying $614 a month with enhanced subsidies. Without them, they're going to pay $3,400 a month, which is $40,000 a year, according to Monahan.
Before COVID and the enhanced subsidies, prices were more manageable, Monahan told KMTV.
"Medical inflation has gotten way, way higher and the insurance companies have gotten much richer and stocks are up, but yes, it's unaffordable now," Monahan said.
However, there are ways to soften the blow. For that same family of six, Monahan explained a potential workaround.
"If you can manipulate his income down from $185,000 to about $160,000 or so, I can get it down to about $1,200 a month," he said.
Monahan says he hates to discourage people from making money: "We're a capitalist country. We want to make more money, but it’s expensive — there’s no way around it.”
He recommends using an insurance broker; reducing your modified adjusted gross income; making less money, if possible, and considering high-deductible plans outside the ACA marketplace. Though, Monahan points out that plans not on the ACA marketplace might not cover all healthcare needs.
Evans is signing up for a direct primary care membership, which will at least cover her doctor's visits. That's a healthcare model sometimes referred to as "concierge care," where a patient pays a monthly fee to a primary care provider for unlimited primary care. It doesn't cover hospital visits or specialized care.
"Say an accident happens and I need surgery, you know, no, that's not going to help me at all," Evans said.
Evans said she's never really been that political, but for her, the next step might be calling members of Congress.
This story was reported on-air by a journalist and has been converted to this platform with the assistance of AI. Our editorial team verifies all reporting on all platforms for fairness and accuracy. In this web story, additional information reported and written by Katrina Markel.
