Healthcare Premiums Have Doubled for Millions
The Issue
Open enrollment began last weekend for the Affordable Care Act (ACA) Marketplace, but the millions of Americans who are logging on to pick or renew their plan for next year are going to face dramatically higher premiums and worse coverage in 2026 – leaving many to question if they can even afford health insurance at all. This is an urgent problem for people living with diabetes.
24 million people rely on ACA plans for their health insurance coverage, which includes everyone from small business owners, contractors, farmers, and early retirees who don’t yet qualify for Medicare. Many of these individuals can only afford plans because of the enhanced subsidies passed by Congress in 2021 to make health insurance more affordable during the pandemic. Those subsidies have now expired. Without them, consumers lose a large portion of federal support that helped to keep monthly premiums manageable. Democrats kept the government in its longest shutdown ever because they wanted to extend these enhanced subsidies to keep ACA plans affordable. Republicans said they will only negotiate these subsidies after the government is funded.
If Congress fails to extend subsidies, premiums could double next year for many plans. The exact amount depends on where you live, your income, and the plan you choose, but the average person will pay roughly twice as much for the same (or in some cases worse) coverage. ACA plan coverage thus far has not been comprehensive for people with diabetes and in the face of rising premiums, many won’t be able to afford these higher costs and will have to forgo coverage or choose high-deductible plans.For people with diabetes, access to healthcare is critical. Without it, paying the list price for insulin, oral medications, glucose testing supplies, and insulin pump supplies can be thousands of dollars per month–just one month of insulin pump supplies can cost $800 a month. On top of that, paying for endocrinologist appointments, blood works (which are often required to get certain prescriptions), retinopathy exams, and more can add up too. For most, managing diabetes without insurance, or trying to navigate complex and constantly changing pharmaceutical programs, is too steep a cost. While there are some Patient Assistance Programs (PAP) and coupons for insulin and testing supplies, most of those require you to have insurance coverage to get the coupon price.
Stories of people with diabetes trying to manage without insurance is not new: Back in 2018, Alec Smith found himself in a similar situation: his employer didn’t offer health insurance and he made too much money to qualify for Medicaid. He found a marketplace plan he could afford for $450 a month, but it had a $7,600 deductible–which means he would be paying the list price for his diabetes supplies until he met that deductible while still paying the $450 monthly premium. So instead, Alec decided to go without insurance. In his first month without insurance he could not come up with the $1,300 for his insulin and so began rationing his insulin. As many of you remember, Alec passed away three days before his paycheck.
It is now up to voters to make sure lawmakers extend the enhanced ACA subsidies so no one runs out of insulin because they can’t afford it.
What You Can Do
You can help urge Congress to reinstate the enhanced federal subsidies that make coverage affordable. It takes one minute to make a call to your lawmakers and tell them how it will affect you.
Find the phone numbers for your Senators and Representatives here.
The Script
Hi, my name is [YOUR NAME], and I’m a constituent from [CITY, STATE].
I’m calling because health insurance costs through the ACA are set to rise dramatically now that the enhanced subsidies have expired. For many people, premiums could double next year, putting coverage out of reach for millions of people.
For those of us living with diabetes, this isn’t just a budget issue — it’s a health crisis. Without affordable insurance, the cost of insulin, glucose monitors, and medical supplies can quickly become impossible to manage. Many families already spend thousands of dollars a month just to stay alive, and losing these subsidies will force many to ration insulin and skip care altogether. [Personalization: Share here what your out of pocket costs would be without insurance, or, what the monthly cost would be under a new plan, and how that would impact you]
Please urge Senator/Representative [LAST NAME] to reinstate the enhanced ACA subsidies to keep health insurance and essential diabetes care affordable. These subsidies save lives by ensuring people can access the medications and doctors they need to stay healthy.
