In Colusa, California, Jean Franklin and her husband, Charles, known as Chaz, face a stark financial reality as health insurance premiums surge. Starting January 1, 2024, their monthly healthcare costs are set to skyrocket from $540 to $3,899. This sudden increase comes as federal enhanced premium subsidies expire, a change that affects millions of Americans.
Jean, 63, who became a stay-at-home mom after saving diligently for retirement, recently received a terminal diagnosis of ALS (Amyotrophic Lateral Sclerosis). The couple, which had planned a comfortable retirement in their three-bedroom home, is now grappling with the implications of rising healthcare costs. “Now, instead of thinking about where we can go in our retirement, we’re asking the question, ‘Are we still going to be able to stay where we are because of the health care costs?’” Chaz reflected.
Financial Strain from Premium Increases
The drastic increase in premiums has forced the Franklins to reevaluate their finances. The couple had initially planned a month-long cruise, which they canceled in light of their new financial obligations. They now owe approximately $2,300 a month for health insurance, which surpasses their mortgage payments and consumes over a quarter of their monthly budget.
They are among the estimated 22 million Americans experiencing similar pressures due to Congress’s decision not to extend enhanced federal subsidies introduced in 2021. These subsidies had significantly boosted enrollment in Affordable Care Act (ACA) plans, more than doubling participation to over 24 million individuals. The Congressional Budget Office has projected that without these subsidies, the number of uninsured Americans could increase by 2.2 million in 2024 alone.
As of January, enrollment in ACA plans had decreased by around 1.2 million compared to the previous year. Experts note that the full impact of these premium hikes may take months to materialize as individuals begin to miss payments and lose coverage. According to Stacey Pogue, a senior research fellow at the Center on Health Insurance Reforms at Georgetown University, those most affected will likely be early retirees and middle-income earners living in high-cost states.
A Morbid Twist of Fate
Jean’s ALS diagnosis allowed her to qualify for Medicare, providing some financial relief by reducing their monthly premiums by approximately $1,600. While this development alleviates some immediate pressure, it underscores the tragic circumstances that led to it. “It’s kind of morbid that, because of my diagnosis, I got put on Medicare right away, so at least we don’t have to pay that out-of-pocket,” she remarked during an interview from her wheelchair.
Despite the relief from Medicare, the couple still faces significant financial challenges. The combined premiums for Chaz’s plan and Jean’s Medicare surpass their previous expenses. The Franklins’ situation is illustrative of a larger trend, where many individuals near retirement age who previously did not qualify for financial assistance are now facing steep premium costs at a time when insurance companies have increased rates in response to market uncertainties.
Critics of the subsidy expiration, including patient advocates, argue that the increased premiums have forced many individuals to consider forgoing insurance altogether. “The young people who are healthy are the first to say, I’m going to roll the dice,” said Rebecca Kirch, executive vice president of policy and programs at the National Patient Advocate Foundation. This trend raises concerns about the health and financial security of those left in the system, who may delay necessary medical treatments.
For the Franklins, maintaining their quality of life has become a shared family effort. Their sons have stepped in to assist with essential tasks like transporting Jean and managing household needs. Chaz has put off dental work due to the high costs associated with insurance premiums. This year, they anticipate drawing an additional $36,000 from their retirement savings, primarily to meet Chaz’s insurance expenses.
Chaz expressed his frustration with the political landscape, calling for more effective solutions to the healthcare crisis. “I wish Congress would get off their butts and solve this issue,” he stated, emphasizing the urgency of bipartisan cooperation on healthcare reform. As he approaches his own eligibility for Medicare at age 65, he remains focused on providing comfort to Jean, who he has been married to for 27 years.
In their shared moments, the couple reflects on their past adventures, from hiking to amateur photography. As Jean navigates her new reality, she finds joy in small moments, like watching their backyard chickens. With family support and a commitment to one another, they continue to face the challenges ahead, hoping for a resolution that can alleviate their financial burden.
The Franklins’ story highlights the broader implications of healthcare policy changes in the United States, and the personal toll these decisions take on families across the nation.
