OPINION: Without the ACA Premium Tax Credit, my family’s health coverage is at risk

Like so many other working families, I don’t know what my family would do without the Affordable Care Act (ACA) premium tax credits. As these credits are set to expire at the end of the year, so many of us are scrambling to maintain access to care as we face rising premiums and skyrocketing costs for everything else. We’re counting on Congress to continue the critical support these credits provide.

I live in Madison, Wisconsin, with my husband and our two terrific little boys, who are seven and 10 years old. My husband and I both work in the fitness industry as trainers and group fitness instructors at a wonderful small gym in Madison. We love our jobs, and we both work very hard helping others each day. We have both been employed here since high school, almost 30 years. Due to the small number of full-time employees at our gym, the owners are unable to provide us with health insurance.   

So, we’ve purchased health coverage for our family through the ACA marketplace for many years. Every year, the price of coverage has risen significantly. The enhanced premium tax credits make a huge difference for us. We pay $460 each month for our family of four. Next year, if the enhanced premium tax credits are not extended, that premium will soar to $700/month.  

Even with that high price, our plan has high copays and a maximum annual out-of-pocket cost of $14,000. We’ve been forced to take on medical debt. We are still paying off a major hip reconstruction surgery that I needed two years ago – our portion of the bill cost us over $20,000. The out-of-pocket payments leading up to and including the birth of our second child totaled over $19,000. We’ve taken out a home equity line of credit to help pay these medical bills.

The large co-pays force us to make many tough choices and strongly consider all of our health care decisions. Recently our younger son hurt his ankle, and I’m embarrassed to say we debated whether to take him for an x-ray. In the end, we did, and it cost us $350. 

Losing tax credit support would create a real crisis for my family. We’ve already cut back on our spending in every way we know how. Along with my husband and I working extra hours, we rarely go out to eat, and any sort of vacation has been out of the question for years. For 2026, we are looking at scaling back sports and other activities our kids enjoy. 

If the subsidy ends, we will need to cut thousands more from our budget – and we don’t know where that would come from. We’re exploring all our options. My husband is even considering finding another job that offers employer-sponsored health coverage. That’s been emotional, because while we’re certainly not above working at a large retailer like Costco, it would mean setting aside the skills he went to college for and the work he truly loves. We are also considering shopping for a cheaper plan, most likely with a higher deductible, but that’s risky for our financial stability. However, with two kids, I certainly don’t want to go without health insurance coverage altogether. These options and decisions are tough, and quite frankly, scary.  

We’re a middle-class family and, like so many others, we’re struggling to make ends meet with prices for food, housing, clothing, electricity, and so much else skyrocketing. We were promised lower costs, but that certainly hasn’t happened. In fact, prices continue to rise, making it more and more difficult to keep our heads above water as we continue to go deeper into debt.  The prospect of our health insurance rising significantly is devastating. It would be a major financial blow to my family.

This isn’t about politics, or polling, or winners and losers in Congress. This affects families in every district—red, blue, and everywhere in between. It’s about real families, real kids, real health. I was enormously disappointed to see that the latest deal to reopen the government does not include a plan to lower the skyrocketing cost of health care. But this fight isn’t over, and we’re still counting on Congress to come together to continue the Affordable Care Act premium tax credits, which my family and 24 million other Americans, urgently need.