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"I might die if I stop going to the doctor," said one Tennessee resident whose premiums jumped from $10 to $1,140 a month.
More than 20 million Americans are expected to see their health insurance premiums more than double next year after Republicans refused to extend a tax credit for those who purchase health insurance on the Affordable Care Act marketplace.
And as the GOP remains firm in its stance that it will not vote to extend the credits in order to end the government shutdown entering its third week and the open enrollment period for ACA insurance fast approaching, Americans in some states are already getting a glimpse into how the price of their insurance will skyrocket in 2026.
On Wednesday, ACA health insurance marketplaces in six states—California, Maine, Minnesota, Vermont, Oregon, and Kentucky—launched "window shopping" tools that allow residents to compare their current insurance premiums with the ones they can expect to pay next year.
Across each of these states, the advocacy group Protect Our Care found plans that are expected to increase dramatically, sometimes to prices several times higher than they were this year.
“There is no longer any doubt about the healthcare disaster Republicans have created,” said the group's chair, Leslie Dach. “Working families can now log onto a computer and see the Republican healthcare betrayal right before their eyes."
Middle-income Americans who are older, but not yet old enough to receive Medicare, are expected to see the steepest increases in their premiums, according to KFF. When Protect Our Care looked at plans for 60-year-old couples making $85,000 a year, the group found staggering results in each state.
In Clay County, Kentucky, the group found that a Clear Silver plan, which charges that couple a premium of $559 per month this year, will cost $2,736—nearly five times that amount—next year after subsidies expire.
A screenshot of California's Affordable Care Act insurance marketplace website shows the price of an Anthem Blue Cross Silver plan for a couple in Mission Viejo, California, in 2025 (L) vs. 2026 (R). (Screenshot from Protect Our Care)
In Mission Viejo, California, premiums for the same couple's Anthem Blue Cross Silver plan would more than quadruple, from $516 per month this year to $2,188 next year.
The same is true in Medford, Oregon, where a Moda Health Silver plan would increase from $622 this year to $2,644.
In Burlington, Vermont, an MVP Silver plan that costs $602 per month this year will spike to $2,577.
While these are particularly egregious examples, KFF estimated earlier this month that the average ACA recipient will see their premiums increase by 114% next year, which the nonpartisan Congressional Budget Office expects will result in more than 4 million people becoming unable to afford health insurance.
State-level estimates from the Center on Budget and Policy Priorities (CBPP) found that across the states that have opened window shopping, costs for many families were doubling, tripling, or worse.
Residents across the country are beginning to grapple with the extraordinary rise in costs they are about to face.
In Tennessee, where more than half a million people pay lower premiums due to the ACA subsidies, a 62-year-old Chattanooga resident, Cheri Roberts, told the Chattanooga Times Free Press that if they are allowed to expire, her current $10 a month premium will explode to $1,140 next year.
"I just had no idea," Roberts said about the expiring tax credits, adding that she sees eight different specialists for varying health issues and has multiple surgeries planned. "I'm not trying to exaggerate, but I might die if I stop going to the doctor."
Julia Tilley, a resident of Harrisburg, Pennsylvania, told PennLive/The Patriot-News that she fears her premiums will soar as Pennsylvania's insurance department predicts a premium increase of 102% on average for its 530,000 ACA recipients.
Though she says she has not yet received a letter from her insurer, Tilley said one of her friends was told their family's premiums were ballooning from $100 to $1,800 a month.
“There’s really no way to prepare for it,” Tilley said. “I mean, how do you suddenly come up with $15,000 more a year? My husband can’t work more because he has a head injury."
Tilley says she already works full-time taking care of her adult daughter, who has autism. "It’s not like I can go get another job," she says. "So we’re stuck.”
She says she has tried on multiple occasions to reach out to her Republican congressman, Rep. Scott Perry, but has not heard back.
According to KFF, 57% of ACA recipients live in congressional districts represented by Republicans, and polls by the organization have suggested that failure to extend the subsidies may hurt their electoral chances.
A poll from early October found that 78% of adults say that Congress should extend the subsidies, including the vast majority of Democrats and independents and even 57% of self-identified "MAGA" Republicans. If the subsidies are not extended, 39% who support extending them have said they'd blame US President Donald Trump, while another 37% say they'd blame Republicans in Congress. Just 22% say they'd blame Democrats.
"Virtually all marketplace enrollees—across states, ages, family sizes, and income levels—will see big premium increases," said Gideon Lukens, a senior fellow and director of health policy research for CBPP. "These are real people facing real consequences if Congress doesn’t act to extend the enhancements as soon as possible."
"What we will not accept is for the ACA premiums to skyrocket on the American people," said Rep. Alexandria Ocasio-Cortez. "And what we will not accept is allowing the teetering of this system to collapse."
Two weeks into the government shutdown that was triggered when Democrats in Congress refused to help the Republican Party rip healthcare subsidies and coverage away from millions of Americans, two of the top progressive lawmakers in the US were resolute Wednesday night at a town hall held by CNN.
Democrats, said Rep. Alexandria Ocasio-Cortez (D-NY) "need to see ink on paper"—legislation that is passed in the House and Senate and signed by President Donald Trump to extend Affordable Care Act (ACA) subsidies—before they agree to a spending package to reopen the government.
"I don't accept IOUs, I don't accept pinky promises, that's not the business that I'm in," said Ocasio-Cortez when CNN reporter Kaitlan Collins asked her and Sen. Bernie Sanders (I-Vt.) whether Democrats would accept "commitments from the White House and Republicans," who have claimed they will hold votes on healthcare after the government reopens.
These losers — the leaders of the Democrat Party — are not serious people. They don't have any clue what they're talking about other than demanding free health care for illegals to vote to re-open the government.
Shame on them. pic.twitter.com/IdygxnEB8r
— Rapid Response 47 (@RapidResponse47) October 16, 2025
Ocasio-Cortez added that she would not support a Republican proposal for a one-year extension of the subsidies, which help millions of Americans pay for monthly health insurance premiums for coverage purchased through the ACA marketplace. Once the subsidies expire—as they are currently set to at the end of 2025—KFF has estimated that the average ACA premium will more than double.
Whether at the end of this year or after next year's midterm elections, said the congresswoman, "what we will not accept is for the ACA premiums to skyrocket on the American people."
"What we will not accept is the doubling of these premiums. And what we will not accept is allowing the teetering of this system to collapse right before everyone’s eyes,” she said.
Republicans have persisted in repeating the baseless claim that instead of opposing skyrocketing health insurance costs, Democrats are refusing to vote for a continuing resolution to reopen the government—which needs 60 votes to pass in the Senate—because they want to give "free healthcare" to undocumented immigrants.
Undocumented immigrants are not eligible for coverage under the ACA, Medicaid, or Medicare. The Republicans' massive, broadly unpopular One Big Beautiful Bill Act stripped legal asylum recipients, green-card holders, and other legal permanent residents of their eligibility for those healthcare programs, a provision which Democrats have called to reverse.
When asked whether the US should provide healthcare for undocumented immigrants at the town hall, Ocasio-Cortez took aim at the "common lie" that's been spread by GOP leaders including Vice President JD Vance—and vehemently defended the established statute, the Emergency Medical Treatment and Labor Act, which requires all hospitals that participate in Medicare to provide emergency treatment to anyone who needs it, regardless of immigration status.
"I don't know about you, but me, as a human being, I don't want to live in a world where if a human being is struck by a car or is getting rushed into a hospital, that people in the ER surgical room are asking for your insurance information or asking for documents before they save your life," said the congresswoman.
Rep. @AOC: “This is a common lie Republicans - especially JD Vance (+ @RepTimBurchett) - keep repeating… undocumented people can’t be covered by federal insurance… and federal law says everyone gets treated in the ER. As it should be.” pic.twitter.com/TYqmiYswP4
— The Tennessee Holler (@TheTNHoller) October 16, 2025
Sanders and Ocasio-Cortez expressed empathy with federal workers who are missing paychecks as a result of the shutdown, and told audience members who are unable to obtain government-backed loans to buy a home or struggling with a loss of income that they aim for the shutdown to end "as quickly as possible."
But Ocasio-Cortez rejected one suggestion from an audience member who pointed out that about 80% of people who benefit from ACA subsidies live in states that voted for Trump and in "rural, mostly Republican areas."
"If the Republicans are so insistent on sticking it to their own voters on this issue, why don't the Democrats just let them?" asked the town hall participant.
The question illustrated how Trump is "dividing this country," said Sanders, who pointed out that he and Ocasio-Cortez have spoken to large crowds in rural, conservative areas as part of his Fighting Oligarchy Tour.
Q: “Most hospitals + people who will lose insurance are in rural areas. If Trump & Republicans are so intent on sticking it to their own voters, why not let them?”@AOC: “That’s the difference between us & Trump. I don’t care if you voted for me, I want you to have health care.” pic.twitter.com/OvUjAcZWLD
— The Tennessee Holler (@TheTNHoller) October 16, 2025
"It also speaks to a big difference between someone like Trump and someone like me, and someone like Bernie," said Ocasio-Cortez. "Trump believes that if you don't vote for him, he doesn't have to be your leader... I don't care if someone voted for me or not. I don't care if someone is a Republican or an independent or a Democrat... That will never change the fact that I'm going to fight for them to have healthcare."
"And that is the difference," she said, "between a strongman and an authoritarian, and a leader of a democracy."
An economy rigged to funnel so much wealth and power to the billionaire class is bad for you and everyone else. It undermines your life in some major ways.
As a coeditor of Inequality.org, I get a lot of fan mail (and a few complaints). Greg B. recently wrote in, “None of my problems exist as a result of someone else being a billionaire.”
My response to Greg: “An economy rigged to funnel so much wealth and power to the billionaire class is bad for you and everyone else. It undermines your life in some major ways.”
I wrote my new book, Burned by Billionaires: How Concentrated Wealth and Power are Ruining Our Lives and Planet, for folks like Greg to talk about how extreme wealth inequality disrupts our daily lives. Here are 10 ways you are being burned by billionaires, pulled from my book.
My analysis doesn’t focus on the behavior of individual billionaires—though some are gnarly ones (while a handful show signs of decency). The problem is the system of laws, rules, and regulations tipped in favor of big asset owners at the expense of wage earners and working folks.
When I’m talking about billionaires, I’m thinking of more people than the 905 US billionaires that together control about $7.8 trillion in wealth. I include the top one-tenth of 1%, the 0.1% of households that have over $40 million on up to the billionaire class. People with wealth north of $40 or $50 million have every need and desire met and easily accumulate power. They’re not just buying mansions and private jets but also lawmakers and media outlets. That’s when we need to sound the alarm about “the billionaires.”
Here are 10 of the ways you are personally getting burned by billionaires:
1. The billionaires stick you with their tax bill. By opting out of their tax obligations, the billionaire class is shifting responsibility on to you to pay for everything from infrastructure to national defense to veterans services.
2. They rob you of your voice and vote. With the billionaire capture of the government, what you think barely matters. Your vote might still make a difference, but only in marginal situations where the billionaires haven’t dominated candidate selection, campaign finance, and policy priorities. The billionaires love gridlock and government shutdowns because they can block popular legislation from happening.
3. The billionaires supercharge the housing crisis—and profit from it. Billionaire demand for luxury housing is driving up the cost of land and housing construction, supercharging the already existing housing crisis. Billionaire speculators are buying up rental housing, single family homes, and mobile home parks to squeeze more money out of the housing shortage. Global billionaires are coming to “tax haven USA” to park their money in US farmland, timber and housing.
4. They inflame existing divisions in society. The billionaires don’t want you to understand how they are picking your pocket. So, they invest heavily—pouring millions into partisan media organizations and divisive politicians—to deflect our attention away from their harmful behavior. Their divisive policy and social agenda drives down wages, worsens the historic racial wealth divide, and scapegoats immigrants.
5. They are trashing your environment. The billionaires are the super polluters and carbon emitters, burning up the Earth with their excessive consumption through yachts, private jets, and multiple mansions. While you’re recycling and walking, they are zooming around in private jets and yachts with the carbon emissions and pollution of small nation states. While we all need to do our part, the billionaires make us feel like chumps for making ecological choices and sacrifices.
6. They are making you sick. Billionaire backed private-equity funds are buying up hospitals and health specialties—along with big pharma drug companies—with the aim of squeezing more out of healthcare consumers. Health outcomes in societies with extreme disparities in wealth are worse for everyone, even the rich, than societies with less inequality.
7. They are blocking timely action on climate change. Fossil fuel billionaires spend millions to block the transition to a healthy future. They fund politicians to declare a bogus energy emergency to keep their coal plants open and shut down competing wind projects. They are literally running out the clock for our governments to take action to avert the worst impacts of climate disruption.
8. They are coming for your pets. Billionaire private equity funds know we love our pets like family members and are sometimes willing to go into debt for their healthcare. To squeeze more money out of us, the billionaires are buying up veterinary care, medical specialties, pet food and supply—and even pet care services like Rover.com.
9. They are dictating what’s on your dinner plate. The food barons—the billionaires that monopolize almost every sector of the food economy—are dictating the price, ingredients, and supply of most food stuffs.
10. They are corrupting charity and philanthropy. Billionaire philanthropy has become a taxpayer subsidized form of private power and influence. As philanthropy gets more top-heavy—with most charity dollars flowing from the ultra-wealthy—it distorts and warps the independence of the nonprofit sector.
11. Bonus: They are buying up and hijacking the media. The billionaires are buying up the media: broadcast, social media, news outlets. We need more news and social media outlets that are independent of billionaires, like this one!
Burned by Billionaires isn’t another gloom and doom book. I talk a lot about what we can do together to fight the billionaire hijacking of our society and democracy. And you can read about our faces on the frontlines in our Inequality.org newsletter every week to see how people are taking action. A few action steps you can undertake today:
1. Talk to your neighbors about these 10 ways they are feeling the billionaire burn. Organize a discussion group of Burned by Billionaires. Don’t act alone. Join with others.
2. Advocate for taxing the rich and ensuring that billionaires pay their fair share. When your neighbor understandably complains about local and state taxes, explain how the billionaire class has lobbied for tax law changes—to shift taxes off the wealthy and onto everyone else; off federal tax systems onto local; off taxes on income from wealth and into taxes on wages.
3. Game-changing campaigns. Advocate for policies that tax billionaire wealth and invest in housing, educational opportunity, and the energy transition away from Earth-cooking fossil fuels. If federal changes are blocked by the billionaires, work at the state and local level. Tax luxury real estate transfers to fund affordable housing. Tax private jet fuel and fund green transit. Tax billionaire inheritances and fund debt-free higher education and job training.
4. Join the satirical resistance: Trillionaires For Trump! We see the power of comedians and late-night talk show hosts. You can join a new comic resistance effort, see www.trillionairesfortrump.org. Have fun while imitating and parodying the powerful billionaires and join their new health campaign, “Go Fund Yourself!”
5. If you haven’t already checked out Inequality.org, the web site I coedit. Please sign up for our weekly newsletter HERE. Every week we lift up action campaigns and heroic “faces on the frontline” of people working to reverse extreme wealth inequality.
If this intrigues you, I hope you’ll buy Burned by Billionaires from your local independent bookstores or online. Learn more at www.burnedbybillionaires.com.