FRANKLIN, Tenn. (WTVF) — For thousands of Americans who rely on health insurance through the taxpayer-funded government marketplace, the new year could bring sticker shock.
Temporary federal tax credits designed to keep Affordable Care Act premiums affordable are set to expire, leaving many families facing costs they say are simply impossible to pay.
One Middle Tennessee couple has already received a letter saying that without tax credits, their premium will quadruple in 2026.
Ragan Grossman has spent more than 20 years in hospitality, seven of them working for herself as a hotel contractor.
"I contract with a hotel, it can be anywhere from six weeks to six months, and then I move on to the next hotel," Grossman said. "It's really fun, because I get to see a lot of our country."
Working for herself gives Grossman flexibility and has been lucrative, but it also means she has to buy her own health insurance. For years, the Affordable Care Act marketplace kept that within reach, especially because she has a pre-existing condition and her husband's former job didn't offer coverage. He's now retired.
But lately, the cost of care has been climbing.
"We were about $750 a month. And then we received a letter in the mail that said the tax credits are going away, and your premium will be $3,090 starting January 1," Grossman said.
The number stunned her.
"I absolutely thought it was a typo at first," Grossman said. "I thought for sure maybe I got someone else's that had a large family or something like that."
The spike is tied to the American Rescue Plan (ARPA) temporarily expanded premium subsidies for ACA plans. They are set to expire unless Congress acts. Without them, families like hers face impossible choices.
"I never thought I would be in a position where I was questioning whether we could afford this $3,000 a month for two people," Grossman said.
Now, she and her husband are considering options they never imagined.
"We moved to Tennessee because I needed to be near my family. And I don't want to move. We don't want to move. I certainly don't want to switch my job. I love what I do," Grossman said.
More than 643,000 Tennesseans rely on ACA marketplace plans. Grossman says it's not perfect, but it's essential.
"Does the marketplace insurance need to be fixed? Yes, but I believe it's an option our country should definitely have," Grossman said.
And she hopes lawmakers understand what's at stake.
"I feel like Congress is going to do the right thing. I hope that they are," Grossman said. "I hope they see the need that millions of Americans need these tax credits to bring the insurance down."
Without the enhanced subsidies, Tennessee enrollees will face higher premiums, leading some to drop marketplace coverage to go uninsured or switch to other plans if available.
According to the Sycamore Institute, analyses suggest average premiums could more than double, with the biggest effects on small business owners, gig workers, rural residents, older adults with incomes over 400 percent of poverty, and households earning between $100,000 and $150,000.
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