This is not a story about people who failed to plan, ignored the rules, or fell through the cracks. It is a story about people who worked, paid their premiums, enrolled in health insurance, and believed it would be there when they needed it. Then the rules changed. 

Across the country, cuts to the Affordable Care Act are quietly dismantling the health security that millions of people built their lives around. Premiums have more than doubled in some markets. Deductibles have hit record highs. Families are being forced into a choice no one should have to make: pay for health insurance or pay for everything else. 

The Coalition on Human Needs asked people on our email list if they were being affected by health insurance changes.  More than 250 responded.  Here are just a few of their stories. 

Jamie is self-employed, nearly sixty years old, and lives in Tennessee. Already paying $600 a month for coverage described as lacking, Jamie’s premium jumped to over $1,200 — leaving no choice but to walk away from the plan entirely. 

“The rise in insurance costs was unrealistic. I had to drop my already lacking insurance coverage completely when my monthly premium increased over $1,200. My pre-diabetic prescription medicine ran out in February. My blood pressure prescription refills just ended. I have a few more weeks of the last refill, since I decided to take one every other day. I have never had to make these kinds of choices before this current political administration began. I worry things are going to get much, much worse.” — Jaime, Tennessee 

Rationing medication. Stretching prescriptions by taking them every other day. These are not isolated stories. They are the predictable consequences of making health coverage unaffordable for people who were already doing everything they could to stay insured. 

For many Americans, the loss of enhanced premium tax credits did not simply mean paying more. It meant losing access to meaningful coverage altogether. According to a recent Commonwealth Fund blog post, some dropped their insurance because premiums became impossible to afford. Others switched to lower-cost bronze plans with deductibles so high that they effectively priced routine care out of reach. 

The consequences are not falling evenly. Black and Hispanic adults, people in the South, those living in rural communities, and adults with disabilities or chronic conditions are among those experiencing the greatest harm— populations for whom health care was already harder to access and afford before a single cut was made. 

Shirley, from Alabama, has worked full-time for 35 years. She earns a paycheck every two weeks and works more than 40 hours a week. None of that was enough to protect her from what these cuts have done. 

“This is the first time in 35 years of working I had to pay $1,800 out of pocket to get my prescription, and another $300 prior to getting my blood pressure medicine. So, I went without my medication for over 3 to 4 weeks before I could save and borrow the money for my prescription.” — Shirley, Alabama 

But the damage does not stop with the marketplace. 

More than 2 million children have already lost Medicaid or CHIP coverage since January 2025. That number will climb. New Medicaid work reporting requirements — set to take effect in January 2027 — will require many enrollees to document at least 80 hours per month of work or qualifying activities, or prove they qualify for an exemption. The people most likely to lose coverage under these rules are not people who are ineligible. They are people who are eligible but can’t fight through the paperwork to prove it. 

Geraldo, a self-employed man in Florida with a pre-existing condition, remembers what life looked like before the ACA. He was uninsured — not by choice, but because no one would cover him. 

“Until the ACA passed, I could not have insurance. The ACA gave me the chance to see doctors without having to pay an extravagant amount of money. It gave me options to see good doctors without feeling like I had to drain my bank account to see them. When I knew that the ACA credits would not be extended, I didn’t enroll because it was simply too expensive. I just pay my medication and doctor’s visits myself, but it limits me. I can’t ever have any kind of emergency. I just hope that I don’t need to go to the hospital because I would not be able to pay.” — Geraldo, Florida 

Nearly half of all working-age adults — 46% — reported that their families struggled to afford health care in 2025. Not only the uninsured. Not just the unemployed. Working or non-working Americans, in every kind of household, in every corner of the country. 

Lily and her husband are among them. They are self-employed in Arizona, have been using the ACA marketplace since 2020, and are trying to put their son through college. For 2026, they enrolled in a new plan — one with less coverage and significantly higher deductibles than before. 

“With the ACA cuts for 2026, our premiums increased quite a bit, even though we chose a new plan that offered less coverage and considerably higher deductibles. I try not to think about it too often, because it feels like we are one health issue away from major medical debt. For us, the ACA cuts have resulted in less coverage for more money, less economic security, and less spending in other areas as a result. I’m angry that this is our reality as Americans, for something as crucial as health care.” — Lily, Arizona 

These stories are evidence of what happens when public policy makes health care less affordable and less accessible for the people it is meant to serve. Behind every increase in premiums, every loss of coverage, and every new administrative barrier is a person forced to make impossible choices: skipping prescriptions, delaying care, borrowing money, or simply hoping they do not get sick. When Jaime, Shirley, Geraldo, and Lily share their experiences, they connect policy decisions made in Washington to the everyday consequences those decisions create, replacing abstract numbers with real people and making it harder to ignore what higher premiums, weaker coverage, and lost insurance truly mean.