Some Americans say they’ll go without health insurance as ACA rates spike

When Kassidy Hooter learned in December how much her health insurance costs were going to rise this year, she went into panic mode.

The Shreveport, Louisiana, resident and mother of three knew she was in dire need of care — Hooter is in the last trimester of a high-risk pregnancy. But the family could no longer afford Affordable Care Act coverage now that a federal tax the grant had expired on December 31, 2025, meaning they would face thousands of dollars in additional expenses.

“We seriously thought it might be cheaper to give birth at home,” Hooter, 24, told CBS News. “Simply because it’s an insane amount of debt to take on.”

Ultimately, Hooter decided to forgo insurance altogether.

A local medical center offered her three months of financial assistance that will allow her to wait until she gives birth in February and until the end of March. After that, she will have to bear any medical costs herself. Her plan now is to get her newborn on Medicaid, a government health plan for low-income Americans, as quickly as possible.

“I just hope for the best,” she told CBS News.

Health insurance as a “luxury”

Since its introduction in 2010, the ACA has been instrumental in reducing the share of uninsured Americans from about 15% to 8%, according to Nima Sheth, vice president of health justice at the National Partnership for Women and Families, a nonprofit advocacy group.

However, the number of people without health insurance is likely to rise if Congress fails to find a solution for the 22 million Americans who benefited from an ACA tax credit, experts warn. The number of uninsured people will increase by an average of 3.8 million each year from 2026 to 2034 without an extension of the credits, the Congressional Budget Office estimated in 2024.

Americans in most states have until Jan. 15 to enroll in an ACA marketplace plan, according to healthinsurance.org.

Without the tax credits, premiums for ACA enrollees who previously relied on subsidies will increase by an average of 114%, estimates KFF, a nonprofit provider of health policy news and research.

“What we’re seeing here is a policy choice — it’s actually turning insurance into a luxury item and medical debt into default,” Michelle Sternthal, acting senior director of policy and strategy at the health care advocacy group Community Catalyst, told CBS News.

The House of Representatives Thursday approved a three-year extension expired ACA tax credits. The bill faces an uphill climb in the Republican-led Senate, although lawmakers believe it could provide a starting point for a compromise that would keep the appropriations alive in some form.

“It weighs extraordinarily heavy on me”

Plantation, Fla., resident Stacy Kanas, whose family also benefited from an ACA tax credit, is now considering going without health insurance after realizing that her monthly premium to cover her and her husband would be $2,500, more than double what she was paying last year to cover them both and her 20-year-old daughter.

“It weighs extremely heavily on me,” Kanas, 59, told CBS News. “My husband had major surgery about five years ago and we don’t want to be insecure.”

Although in good health, the small business owner worries about what could happen if a member of her family becomes seriously ill. “You are one catastrophic event away from financial disaster,” she said.

Even people who keep their ACA coverage could end up missing out on care to avoid out-of-pocket costs, experts said.

“If you’re underinsured and your deductibles are high, the coverage you have is designed to discourage seeking care, including preventative care, so you’re going to delay your care until there are emergencies,” Sternthal said.

Robert Myers, a consultant based outside St. Louis, Mo., was on an ACA silver plan last year but switched to a bronze plan after learning his premiums would increase to $400 a month, up from $17 in 2025. Under his new plan, the 31-year-old has no monthly premium. However, Myers may have to pay significantly more in out-of-pocket expenses due to an $80 co-pay and $8,000 deductible.

When people skip medical appointments, experts say emergency rooms end up becoming the primary place of care.

“They’ll kind of go to the emergency room and get what they need fixed with a bandage and then not get long-term care,” Sheth said.

This can have broader ripple effects, as an increase in uncompensated hospital care can drive up costs for other patients as facilities seek to recoup costs, according to Sternthal.

“Each delay locks families into decisions that harm their health and financial stability, but also impacts the business world and local community,” she said.