{"id":288999,"date":"2025-11-13T11:13:25","date_gmt":"2025-11-13T11:13:25","guid":{"rendered":"https:\/\/www.newsbeep.com\/us\/288999\/"},"modified":"2025-11-13T11:13:25","modified_gmt":"2025-11-13T11:13:25","slug":"older-texans-among-those-paying-the-most-for-aca-insurance","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/us\/288999\/","title":{"rendered":"Older Texans among those paying the most for ACA insurance"},"content":{"rendered":"<\/p>\n

Audio recording is automated for accessibility. Humans wrote and edited the story. See our AI policy<\/a>, and give us feedback<\/a>.<\/p>\n

Of all the topics 55-year-old Groves resident Theresa Hebert has discussed on her TikTok account @foolish_mortal999<\/a> over the past five years, nothing has brought in new viewers like her recent anxiety over expected Affordable Care Act health insurance price hikes.<\/a> Not even her battle with breast cancer.<\/p>\n

\u201cWith the current government shutdown and the threat of not extending the subsidies for the Affordable Care Act, I\u2019m a bit worried,\u201d she told viewers last month. <\/p>\n

Her plan costs $581 a month and it\u2019s helped cover four surgeries, 16 rounds of chemotherapy and 30 days of radiation this past year. Her plan is made somewhat affordable after receiving $250 a month in subsidies enacted under the Biden administration. <\/p>\n

But those subsidies that have helped bring down the cost of monthly premiums for ACA plans, also called enhanced premium tax credits, are set to expire at the end of the year. Starting next year, Hebert\u2019s monthly premium will rise 87% to $1,091, just slightly less than her $1,400 monthly mortgage.<\/p>\n

\u201cIt\u2019s not ideal,\u201d Hebert, whose job as a property manager doesn\u2019t offer health benefits, told The Texas Tribune. <\/p>\n

Texans over the age of 45 are among those statewide who are seeing the highest rise in their premiums this open enrollment, which closes Jan. 15, according to health policy experts.<\/p>\n

More than one-fourth of the state\u2019s 4 million ACA enrollees are between the ages of 45 and 64.<\/p>\n

For a 60-year-old Texas couple with a total income of $85,000, the Center on Budget and Policy Priorities estimates<\/a> enhanced tax credits would have capped their annual premium for a silver plan at $7,225, but that would jump to $33,689 if the enhanced subsidies expire. <\/p>\n

On Oct. 1, the federal government shut down after Republicans and Democrats failed to pass a bill funding government services from that day forward. Although Republicans hold a majority of seats in both chambers of Congress, they were short votes in the Senate needed to pass the spending bill. For more than a month, Democrats would not sign on unless the tax credits were extended. But on Monday, the Senate passed a spending plan<\/a>, 60-40, without the ACA tax credits extension<\/a>, as the Democrats had once demanded.<\/p>\n

Without those subsidies, many ACA plan consumers are feeling forced to either find a way to pay for their more expensive existing plans, sign up for a less expensive plan with higher deductibles or forgo insurance entirely and hope that they remain in good health. On average, Texas insurers have increased ACA premiums by 35%<\/a> but for older ACA enrollees who already pay more, the hikes are even higher. <\/p>\n

\u201cSo price impacts tend to hit older folks the hardest,\u201d said Laura Dague, who is the James M. Griffin professor of health policy at Texas A&M University.<\/p>\n

The reason is simply the higher amount of health problems older individuals experience. <\/p>\n

\u201cIn general, they\u2019re higher risk,\u201d Dague said. \u201cThat means that insurance companies have to charge them more.\u201d<\/p>\n

Older enrollees, especially those in their 50s and early 60s have been stunned to see whopping hikes in their premiums.<\/p>\n

As she\u2019s had to repeatedly explain to younger TikTok viewers who tell her to \u201cjust go on Medicare,\u201d Herbert has 10 more years before she would be eligible for the cheaper, government-sponsored plan for those Americans over the age of 65. <\/p>\n

For now, she\u2019s struggling with the news as she weighs her options. <\/p>\n

There are cheaper ACA plans that still cost around $700 a month, but they could provide less coverage and force her to pay more out of pocket before the plan starts to cover more services. If she changes plans, she may not keep her current doctors. When asked what she intends to do before open enrollment ends Jan. 15, all Hebert can say is: \u201cI have no idea. I have no clue.\u201d<\/p>\n

For the most part, older Texans are willing to pay the higher ACA prices because the only other option is to be uninsured. The tough part for Hebert and Texans like her is now coming up with so much more money to keep their coverage going. If they go with a cheaper plan, they worry if they will have vital prescriptions covered or whether they\u2019ll be forced to restart their health care with new providers or those who are located further away. <\/p>\n

This year, subsidies reduced the monthly price of G.W. Babb\u2019s plan from $860 to zero. Next year, the 63-year-old Austin graphic designer\u2019s insurance company will raise its rate to $1,270, and he will lose about half of the subsidies he received. As a result, he\u2019ll go from paying nothing to paying $870 a month for health coverage.<\/p>\n

To make his situation worse, Babb\u2019s doctor of the past 20 years is not in the network of this new plan. <\/p>\n

So Babb said he will have to pay $150 per visit out of pocket to continue seeing this provider on top of the $870 monthly premium.<\/p>\n

\u201cGoing from paying nothing to paying nearly $900 a month is insane,\u201d Babb said. \u201cEven without all the subsidies, it\u2019s still $400 a month more than what I\u2019m paying right now.\u201d <\/p>\n

Hebert and Babb\u00a0were hoping the tax credits would be extended as part of the federal shutdown negotiations.<\/p>\n

Hebert said news that SNAP federal food assistance was first on hold<\/a>, then delayed<\/a> for November because of the federal shutdown weighs on her.<\/p>\n

\u201cI don\u2019t want people to go hungry. But I also, I need for, I really need for the subsidies to be extended,\u201d she said. <\/p>\n

\"TopTop left: Theresa Hebert\u2019s results after updating her information on the ACA Marketplace website at her home in Groves on Nov. 1, 2025. Top right: Hebert\u2019s coffee cup, gifted to her by her good friend and roommate while undergoing cancer treatment, sits on a table in their living room. Bottom: As their dog Bentley looks on, Hebert, left, and her good friend and roommate, April Dattalo print out Hebert\u2019s results after updating her information on the Marketplace website. Danielle Villasana for The Texas<\/p>\n

She\u2019s stunned by how little some of her younger TikTok audience and the more privileged older ones understand how the federal government operates and how they see the tax credits as some sort of something-for-nothing welfare grab. <\/p>\n

\u201cPlease forgive me for the whopping $250 in subsidies that I\u2019ve received for the past 14 months even though I\u2019ve never received literally any form of assistance in any aspect of my life,\u201d she clapped back at her viewers recently, reminding them she\u2019s paid taxes for 40 years. <\/p>\n

The engagement on her account has boosted viewership. As anguished as her story has been, the tension over the rising cost of health care, told in real time through social media, is resonating with both supporters and detractors. It\u2019s helped her to get closer to 10,000 followers she needs to get paid by the app for her content. She sardonically muses that may be one way to help her stay with her current insurance plan. <\/p>\n

\u201cCome for me more, please\u201d she told her viewers over a week ago. \u201cThe more you guys do that \u2026 and I\u2019m going to get to 10K [followers] and then I\u2019m going to be able to get monetized \u2026 and then you won\u2019t have to hear me complain about how fucking expensive my health insurance is.\u201d<\/p>\n

By Tuesday, she\u2019d reached 10,200 followers. <\/p>\n

Dan Keemahill contributed to this story. <\/p>\n

Disclosure: Texas A&M University has been a financial supporter of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune\u2019s journalism. Find a complete\u00a0list of them here<\/a>.<\/p>\n

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