People who buy their health insurance through the Affordable Care Act marketplace are seeing monthly costs for next year skyrocket, as the federal government ends enhanced subsidies.
For Celeste Jameson, 41, a paralegal who lives in North Port, the monthly premiums next year will more than double, from $266 to $593.
"I can't afford $593 a month. I just can't, on top of all of my other living expenses," Jameson said.
As a young adult, she suffered from severe abdominal and pelvic pain that went undiagnosed until just over 10 years ago, when she was finally able to get reliable health insurance through the exchange.
"I was in and out of hospitals with severe pain, ovarian contusions and everything, with no insurance," she said.
The bills piled up. She got into medical debt.
Buying health insurance through the ACA at the start of 2014, for about $25 a month, "was a lifesaver for me because, in May of 2014, again, I had to be rushed to the emergency room. It was probably like the worst pain I had ever had," Jameson said.
One of the doctors decided to do exploratory surgery.
"And then that month, I was diagnosed with endometriosis," she said.
It's a condition that about 1 in 10 women have, where tissue similar to the lining of the uterus grows in other parts of the body.
Once she felt better, she was able to take on regular work as a paralegal. She credits her health insurance with finally helping her get the diagnosis that led to her improved health.
She has not yet renewed her insurance for next year.
"It scares me to know or to even imagine that I could be back where I was before 2014," she said.
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A lot of people are in the same boat.
The tax credits were legislated by Congress in the 2021 COVID-19 relief package known as the American Rescue Plan Act, then extended through 2025 under the 2022 Inflation Reduction Act.
"The problem is in the younger generation because the price has gone up, it is going to cause people to get out of the insurance pool. It's called a death spiral in the industry," said Jack Roken, a health insurance broker in Hallandale Beach.
To make up for those losses, insurance carriers have to raise rates.
"That's the double-whammy effect. The subsidies go down, people leave and then suddenly the prices for those remaining go up dramatically," Roken said.
Florida is getting hit hard. For one, it never expanded Medicaid. And it's a big state with the largest percentage of people in the nation getting insurance from the ACA.
Many are professionals working at jobs that don't provide health coverage, like Jason Lago, 39, a psychiatric mental health nurse in St. Petersburg.
His husband, Chris Palmer, is a kayaking tour guide in Shell Key. They are both in good health. Lago's income rose last year, so their insurance is going from $143 a month to more than $1,200 a month.
"At this point, basically, I'm looking at getting some kind of like catastrophic insurance coverage, if that's even possible," Lago said.
"I'm more than willing to pay my share of whatever I have to. But $1,200 a month is, in my mind, extremely unreasonable, and I don't think I'll even need a portion of that," Lago continued.
Deciding whether to keep health insurance and what kind of insurance can fit into one's budget is not an easy decision —especially for those with health issues.
Shane Bonar, 33, works as a server in Orlando. He recently found out several people in his family have a genetic heart condition.
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"I've just started to this year have symptoms as well. Led me to go to the emergency room already once, and they were able to tell me that I need to see a cardiologist. But I don't know that I'm going to be able to do that without health care," Bonar said.
For him, the cost is going up by several hundred dollars a month. And his plan has a high deductible, so the first $8,000 in charges come out of his pocket.
"I understand that the Affordable Care Act may not be the best thing in the world, but not having anything in place for people on the back end is what's really scary to me," said Bonar.
He, like many others interviewed for this story, would like to see some form of universal health care that's affordable and covers everyone.
Senate Democrats have said they were holding out on reopening the government until Republicans agreed to extend the tax credits. Bonar says he feels let down after the shutdown ended without health care concessions.
"I feel like that's the biggest takeaway from all of this. I don't feel like I have any representation," he said.
It's unclear if lawmakers will extend the subsidies by the end of the year. A bipartisan agreement could be difficult to reach by then.
The deadline for most ACA plans is a month away,
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