In Sugar Grove, North Carolina, Ross and Rebecca Tobiassen recently ended their health insurance due to rising costs. They had relied on the Affordable Care Act (ACA) for subsidised coverage since it launched in 2014. In December, they noticed their monthly premium would jump from $130 to over $550, making it unaffordable for them.
The couple owns a small auto shop and are the only employees. Rebecca is concerned about her husband’s safety at work, as he has suffered injuries before, including becoming mostly blind in one eye after an infection. The Tobiassens represent many Americans who have dropped their ACA coverage after enhanced tax credits expired in 2025. An analysis predicts that ACA enrollment could fall from 22 million to 16.5 million by 2026 due to rising costs. In North Carolina, signups dropped by 22%, affecting over 213,000 people.
Many people, including those working part-time or in gig jobs, are opting for less expensive plans with less coverage. This trend worries experts, as it could lead to higher costs for those who remain insured. Without subsidies, families often cannot afford the premiums or deductibles, creating a problem known as a “death spiral,” where rising costs discourage participation.
The Tobiassens currently have no backup plan if unexpected health issues arise, relying on savings and support from family.
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