Kara Windeler has dealt with chronic health problems since she was six weeks old. Now higher health insurance costs may force her to leave the plan she relies on for specialists, medications and ongoing treatment.
Windeler said she sold the home she had owned for 17 years in 2024 so she could continue paying for her care. The proceeds became a financial safety net, but she told CNN that the money has now been exhausted by health care costs.
Windeler said she reviewed what had been billed to her insurer during 2025 and found that the total exceeded $200,000, an amount she said she could not absorb herself.
CNN reported that she may have to end her current coverage in November because of the cost. Windeler said her most likely next step is a substantially cheaper plan.
Changing Plans Could Mean Starting Over With Specialists
For Windeler, moving to a less expensive plan would involve more than lowering a monthly premium. She said her chronic autoimmune conditions require multiple specialists, testing and medications, and that the providers and treatments she currently uses may not be covered under a cheaper plan.
She told CNN that finding replacement care could mean starting over with specialists and medications, noting that treatments for chronic autoimmune conditions do not necessarily work on the first attempt.
Windeler said she has reached the point where she is “liquidating little pieces” of her life to keep paying for care and does not yet know what her long-term solution will be.
Enhanced ACA Tax Credits Expired at the End of 2025
The additional Affordable Care Act premium assistance available during the previous several years ended Dec. 31, 2025. HealthCare.gov warns returning Marketplace customers that people who still qualify for savings in 2026 are likely to pay more for their premiums.
The enhanced premium tax credits were established through the American Rescue Plan in 2021 and extended through 2025 by the Inflation Reduction Act. They increased assistance for people already eligible for Marketplace subsidies and temporarily removed the 400%-of-poverty income ceiling for premium-tax-credit eligibility.
A KFF analysis found that the average monthly net premium payment among all Marketplace consumers increased 58%, from $113 in 2025 to $178 in 2026.
KFF also found a substantial shift toward bronze plans, which typically trade lower monthly premiums for greater cost sharing. Bronze plans accounted for 40% of Marketplace selections in 2026, up from 30% the previous year.
KFF found that the average deductible in ACA Marketplace plans increased by $1,027, from $2,759 to $3,786. The organization said much of that increase reflected consumers moving away from lower-deductible silver coverage and into plans with higher deductibles.
Compare Provider Networks and Drug Coverage Before Switching Plans
For people with chronic conditions, a lower premium does not necessarily mean lower overall health spending. Provider networks, deductibles, prescription coverage and other out-of-pocket costs can change from one plan to another.
HealthCare.gov lets consumers compare plans using their doctors, medical facilities and prescription drugs. It also provides links to each plan’s provider directory, drug list and Summary of Benefits and Coverage.
Consumers can verify provider participation through an insurer’s directory or by contacting the insurer, and HealthCare.gov also recommends checking with the medical office directly.
Marketplace customers should update expected household income and other application information because those details can affect premium-tax-credit eligibility and the amount of financial assistance available.
People who believe the Marketplace made an incorrect decision about their eligibility or financial assistance may also have appeal rights. HealthCare.gov says consumers generally have 90 days from the date of an Eligibility Notice to request an appeal.