‘Terrified’ Americans are faced with life-or-death choice after sky-high Affordable Care Act price hikes

Rachel Phipps lies awake at night with crippling anxiety, thinking about what will happen when she no longer has health insurance.

The 63-year-old retired social worker is one of the 22 million Americans enrolled in the Affordable Care Act program whose monthly premium has skyrocketed after enhanced subsidies expired on Dec. 31.

“I wake up in the middle of the night and I’m terrified of a catastrophic illness or accident happening,” Phipps, a mother from Kennebunk, Maine, told The Independent. “I’m terrified of something happening and going bankrupt.”

If the group of bipartisan senators currently wrangling over the revival of the enhanced Obamacare tax credits fails to do so, Phipps said she has no choice but to cancel her health insurance.

Last year, Phipps’s monthly premium was $201, thanks to the enhanced subsidies. It’s a very different picture one year on.

“My husband and I were informed that our premium this year would be $2,864 a month, with an annual deductible of $7,500 per person,” Phipps said.

“We calculated that if we took that plan, our health care premium and deductible costs for the year could cost us up to $49,368, which is approximately 45 percent of our annual income.”

To make matters worse, Phipps has a chronic respiratory condition and is being treated by a dermatologist for pre-cancerous cells on her face.

“I have no insurance to cover these conditions,” she said. “I can’t afford CT scans or X-rays or anything diagnostic, which is scary.

“We are literally two adults who have worked our entire lives — and we cannot get insurance anywhere.”

The enhanced subsidies, introduced in 2021 during the Covid-19 pandemic, were a lifeline for lower and middle-income Americans. People with incomes up to 400 percent of the federal poverty level — $62,600 for one person or $128,600 for a family of four — were eligible to claim.

Many Americans who signed up for Obamacare plans and benefited from the now-lapsed subsidies are running out of options. They make too much to qualify for Medicaid, but are too young to sign up for Medicare.

Phipps and her husband, who is self-employed, enrolled in a plan via the ACA marketplace in early 2025 when Phipps was forced to retire early to look after her elderly mother, who died last year.

Even if the subsidies are extended for another three years, Phipps has started working part-time in a pre-school, which has pushed her income just over the threshold to qualify.

“A lot of people will fall through the cracks,” she said.

Phipps wrote to Republican Sen. Susan Collins — who is leading the Senate negotiations with Sen. Bernie Moreno — and Independent Sen. Angus King, appealing for their help at the end of last year before the subsidies lapsed.

“I might be one of the 51,000 people who you have heard will die this year,” Phipps wrote to the Maine senators. She has become so exasperated by the U.S. healthcare system that she is running for a seat in the Maine House of Representatives.

For Americans like Phipps who are staring down the barrel of expensive medical treatment, it is a particularly unnerving time now that the lifeline hangs in the balance.

Last year, Dawn Wheeler spent weeks worrying about how she was going to afford treatment she regularly undergoes for metastatic cancer. She was diagnosed with breast cancer eight years ago, which spread to other parts of her body.

Her initial quote for 2026 would have seen her paying a monthly premium of $2,700, but thankfully for the mother-of-five and her husband, they qualified for an income-based subsidy that brought it down to $272.32.

Still, after the pandemic-era subsidies expired, it is a leap from the $69 per month Wheeler was paying last year, and her deductible has gone from $0 to $3,000.

“The anxiety that this has produced does not help people like me who are fighting chronic illness,” Wheeler, from Edwardsville, Kansas, told The Independent.

At her lowest moments last year, Wheeler said she often thought about her death if she could no longer afford insurance.

“It would just be a slow, painful death,” she said. “Maybe not even a slow one. It might be pretty quick, and that’s what people are facing.”

Wheeler undergoes infusions every two weeks and requires MRI and CT scans every two months so doctors can keep a close eye on the cancer.

In addition to an increase in her monthly premium, the grandmother has seen her primary care visit copay costs more than double from $15 to $40, while the copay for a specialist visit has gone from $30 to $80.

“My drugs, my chemo … it’s thousands of dollars a month,” Wheeler said. “I usually hit my out-of-pocket by the end of January, so I’m not sure what’s going to happen this month.”

Wheeler hit back at critics who argue that the subsidies were introduced during the pandemic, so people should manage without five years on.

“Look at your grocery bill. Look at all your bills,” she said. “Everything has gone up since Covid. We need it more than ever.”

Elsewhere, Johana Scott, a Texan battling Stage 3 cancer, warned earlier this month that without her health insurance, she was “going to die this year.”

Scott said that her premium spiked from around $200 per month to $1,725 for the same plan after the subsidies expired.

Paying that much each month is impossible, as she only makes $1,200 per month, she said. Assuming she could come up with the total, she said she’d have nothing left for groceries or bills.

“I’ve been crying since December because I don’t know what to do,” she said. “If I don’t have my insurance, I am going to die this year.”