Deciding to drop insurance

KFF Health News published a more qualitative feel for what the expiration in premium subsidies means for families across the nation. The main family that was profiled saw that their monthly premiums "would jump from $130 to more than $550" and decided to cancel their health insurance. Their decision is especially notable given the previous injuries from their work. In the family's state of North Carolina, "individual ACA sign-ups for 2026 were down 22% compared with the year before." A nonprofit organization in the same state saw nearly 100 clients (out of about 700 that they worked with during open enrollment) decide similarly to drop insurance. The article points out that such large drops in coverage could be the start of a "death spiral," where "healthier people drop out of the risk pool, fewer people subsidize the people who get sick... That means premiums for the people who get sick will increase again in the future."

While not the only factor, one underlying cause of the rise in insurance premiums is the rise of health care itself. Without addressing that factor, debating whether subsidies should continue only considers who should shoulder the cost of care, and to what extent (whether that be taxpayers or individuals).