![\"health](\"https:\/\/www.newsbeep.com\/ca\/wp-content\/uploads\/2025\/10\/ec7c36eccbc763bff452342d0713a6986c-health-care-costs.rsquare.w400.jpg\")
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My Two Cents<\/a><\/p>\n \n Personal-finance columnist Charlotte Cowles asks the nosy, revealing, sometimes uncomfortable questions about money so you don\u2019t have to.\n <\/p>\n \n Photo-Illustration: by The Cut; Photos: Getty Images\n <\/p>\n It\u2019s almost open enrollment season, the annual American routine of wondering why the hell we pay so much for health insurance that isn\u2019t even that good. This year, it\u2019s not just worse than ever \u2014\u00a0for many people, health insurance might become unaffordable, full stop.<\/p>\n \u201cI\u2019m used to my health-insurance costs going up,\u201d said one friend \u2014\u00a0a woman in her 40s \u2014 \u201cbut this is insane.\u201d She recently got a letter from her insurance company saying that her premiums would increase by $100 per month in 2026. She\u2019s outraged, but she\u2019s also stuck \u2014\u00a0it\u2019s still the cheapest option she can find.<\/p>\n She might be one of the lucky ones. If you get your health insurance through the Affordable Care Act marketplace \u2014\u00a0as 24 million Americans do<\/a> \u2014 then your monthly premiums could potentially more than double in 2026. For the average family enrolled in an ACA plan, that would look like a 114 percent increase from an average of $888 in 2025 to $1,904 in 2026, according to a report from KFF<\/a>, a nonprofit organization that collects and analyzes health-related data. And that\u2019s before anyone even goes to a single doctor\u2019s appointment.<\/p>\n Yes, the government is largely to blame<\/a>; ACA enhanced premium tax credits are set to expire at the end of this year, and if they do \u2014 despite Democrats shutting down the government in protest \u2014 then millions of Americans across the economic spectrum will see their health-insurance rates soar. It would be nice if someone stopped this from happening<\/a>, but so far, no dice<\/a>.<\/p>\n That\u2019s only one piece of the problem, though. Even if you get your health insurance through your employer (and not the ACA marketplace),\u00a0you\u2019re going to see higher-than-normal price increases. Employer-sponsored health-insurance premiums are expected to jump 6 to 7 percent, with some analyses<\/a> showing an average employee cost increase of around 9 percent. That\u2019s the biggest spike in more than 15 years, according to projections from Mercer<\/a>, which conducts an annual national survey of employer-sponsored health plans.<\/p>\n \u201cThis is not a normal year or a normal situation, no matter whether you are signing up for Medicare or an Affordable Care Act plan or have commercial or employer-based insurance,\u201d says Cindy George<\/a>, who analyzes health-care costs for GoodRx, a health-care platform that provides telehealth services and prescription medications. \u201cThere\u2019s upheaval across the board.\u201d<\/p>\n The reasons for this are complex. \u201cThere\u2019s a compounding effect,\u201d says Elizabeth Fowler<\/a>, a professor at Johns Hopkins Bloomberg School of Public Health. \u201cThe cost of health care and utilization has gone up, and that\u2019s affecting everybody\u2019s premiums.\u201d (Experts also point to the aging American population and growing prevalence of chronic medical conditions, which drive up the need for medical services<\/a> and, in turn, the cost of everyone\u2019s insurance.) \u201cAnd if the enhanced subsidies for the ACA exchange policies expire, that will raise premiums even more,\u201d she adds. But these costs won\u2019t hit everyone equally: \u201cIt varies by family, by geography, by coverage that you get. So there\u2019s a lot of factors that go into figuring out what, exactly, the impact on you as an individual or a family is going to be.\u201d<\/p>\n What\u2019s more, there\u2019s less competition in the health-insurance industry these days<\/a>, allowing fewer companies to dominate the market and raise prices because they can. \u201cOur current government is not keen on regulation,\u201d says Heather Boneparth, a former lawyer who worked in the insurance industry for a decade before she became a director at Bone Fide Wealth<\/a>, a financial advisory firm. \u201cAnd without the government putting checks and pressures on these companies, then they will pass their rising costs onto us, which is a piece of what we\u2019re seeing.\u201d<\/p>\n Whether or not something can or will be done about this, we\u2019ve got a deadline: Everyone needs to choose a health plan before their open enrollment period ends. If you get health insurance through your employer, that could be soon; if you\u2019re getting it through the ACA marketplace, you have until January<\/a>. No matter what, though, your options won\u2019t be great. \u201cThere are no good deals in health insurance,\u201d says Boneparth. But there are ways to make a more informed choice. Here are the steps for finding a plan that will hopefully cost you the least amount of money and stress.<\/p>\n Before you look at your options, consider your current health-care needs, says George. Sure, you can\u2019t anticipate a freak accident, but you probably have a general idea of what medical care you\u2019ll need in 2026. George recommends asking yourself the following questions: Are there any doctors you must see or that you strongly prefer? Do you or anyone in your family require specialized care for a chronic medical problem? Do you think you\u2019ll need surgery or another procedure soon? Are you pregnant or planning to be? Do you see any health-care providers that you want to make sure are covered by your insurance? Do you travel a lot, which might necessitate seeing doctors that are out-of-network? These are all important factors in choosing your plan.<\/p>\n If you\u2019re relatively healthy and don\u2019t visit the doctor beyond annual checkups or the occasional illness, then you can feel good about picking the cheapest plan you can find. \u201cThat\u2019s what I do, and what many people do,\u201d says Fowler. It also might be your only real option if you can\u2019t financially accommodate a plan with higher premiums.<\/p>\n When choosing a health-insurance plan, there are two numbers to pay the most attention to: your monthly premium costs and your deductible, which tend to be inversely related. For the most part, the higher your monthly premiums, the lower your annual deductible; the lower your monthly fees, the higher your deductible. You\u2019re essentially calculating your own risk of getting a big medical bill and betting on or against it.<\/p>\n Your premium is the monthly fee you pay for health insurance. If you get insurance through your employer, this usually comes right out of your paycheck; if you procure it separately, you have to pay for it yourself (automate this so you don\u2019t forget!). If you miss a payment, your insurance will lapse as soon as the end of the month.<\/p>\n A deductible is a fixed amount of money that you\u2019ll be responsible for paying, out-of-pocket, for qualifying medical bills whenever they come up. Once you hit that number, insurance will take over and cover most or all of the rest. (For instance, if your deductible is $5,000 and you get a $10,000 medical bill, you\u2019ll have to pay $5,000 of it and your insurance should foot the remainder.) It functions as a limit for what you\u2019ll be on the hook for, which can be comforting (and can save you money), especially if you\u2019re anticipating some big bills.<\/p>\n If you or someone in your family is getting surgery, giving birth, or will require expensive treatment for a medical condition,\u00a0then it might be more strategic to get a plan with higher monthly premiums and a lower deductible, says Boneparth. \u201cWe\u2019ve done both in our family, and when we had young kids, we were always blowing through our deductible,\u201d she adds. \u201cKids can really change the calculation.\u201d<\/p>\n If the plans offered through your employer or the ACA marketplace are out of reach, it\u2019s time to look farther afield. George recommends seeing if you qualify for a catastrophic health plan, which usually has much lower monthly premiums than standard health-insurance plans (the downside: much higher deductibles, copays, and out-of-pocket costs). \u201cIt guards against a worst-case scenario,\u201d she says. It\u2019s not good, but it\u2019s better than nothing \u2014\u00a0if you can get it. Many people over 30 will have a hard time qualifying for a catastrophic plan, but if you can prove that your other health-insurance options will cost more than a certain percentage of your household income<\/a>, you should be eligible.<\/p>\n You should also check if you qualify for Medicaid, adds George. If you receive SNAP benefits, you probably are; if you suspect you might be, it doesn\u2019t hurt to apply<\/a>. If you have children, see if they\u2019re eligible for CHIP<\/a>, which they can qualify for if you make too much money to receive Medicaid. (You can also be eligible for CHIP if you\u2019re pregnant.)<\/p>\n If you\u2019re struggling to find an affordable option within the ACA marketplace, you can also call one of your state\u2019s health navigators; it might take you a while to get through to someone, but it\u2019s their job to answer your questions. If you get health insurance through your employer, your HR department should be able to help you, too. And when you\u2019re researching plans, reach out to health-insurance companies directly with specific questions about the cost of medications you take or doctors you hope are in-network. Many of them have helplines specifically for this purpose.<\/p>\n Right now, we\u2019re operating with incomplete information \u2014\u00a0no one knows if Congress will get its act together and extend the health-care subsidies. But if factors shift within the open-enrollment period, you can still switch your plan, says George. Just make sure you know your deadline.<\/p>\n The whole point of having health insurance is, in theory, to protect yourself from unaffordable health-care bills. But this year, many Americans may face an enraging choice: Sign up for a health-insurance plan that will stretch them impossibly thin, or take the risk of forgoing health insurance completely.<\/p>\n Not only does being uninsured put you at risk for a bankrupting medical bill<\/a>; it also exacerbates the larger problem of ballooning health-care costs. \u201cPeople will decide not to enroll in health insurance because they can\u2019t afford it, but the people who need coverage the most \u2014 maybe they have a chronic condition, they\u2019re going through a treatment for cancer or some other disease \u2014 those folks will pay whatever it takes because they need it,\u201d says Fowler. \u201cThe effect of healthy people dropping out and the sick people staying in is that premiums will go up even more. There\u2019s this death-spiral impact.\u201d<\/p>\n If that makes you angry, good. It should. Call your representatives. Reach out to the Congressional Budget Office. Get your friends and family members to do the same. This isn\u2019t normal, and it shouldn\u2019t be.<\/p>\n Email your money conundrums to\u00a0mytwocents@nymag.com<\/a> (and read our submission terms here<\/a>.)<\/p>\n