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Millions of middle-income Americans will see their health insurance premiums increase dramatically next week. Congress failed to pass legislation to extend expiring subsidies for people who buy insurance through the Affordable Care Act marketplace. In many households, women are the ones making health insurance decisions. Health reporter Lynn Arditi spoke to some of them about what's at stake.
LYNN ARDITI, BYLINE: B lost her job last spring. The Rhode Island woman had to switch her family's health coverage to an Affordable Care Act plan. It costs nearly $2,000 a month. That was a lot, but without the government subsidies, it will rise to almost $3,000 next year.
B: I don't have an additional almost $900 laying around in my family budget to pay for this.
ARDITI: B asked to be identified by her middle initial because she's looking for a new job and worries that her insurance needs might affect her job search. As the enrollment deadline loomed, B had another idea. She'd drop health coverage for herself and her husband. They would just cover their kids, but it'd be risky.
B: My husband works with major tools all day, so yeah, it feels like rolling the dice.
ARDITI: All over the country, women like B are trying to figure out what to do. Elizabeth Tobin-Tyler is a professor at Brown University School of Public Health.
ELIZABETH TOBIN-TYLER: There's a disproportionate role that women play in families around what we think of as, like, the mental load.
ARDITI: B has already been pulling money out of her retirement to pay for their current coverage, $12,000 so far. She kept researching, though, and now has a new plan. She'll use retirement funds to cover just herself and her husband, and the kids will be covered for free on Medicaid.
B: The bottom line is none of this is affordable, so we're going to be dipping into savings to pay for this.
ARDITI: Cynthia Freeman (ph) and her husband had also been relying on an ACA plan for coverage. They're freelance artists in Brooklyn who work in storytelling and podcasting. Without the subsidies, their new premium will be more than $700 a month.
CYNTHIA FREEMAN: If we didn't have health issues, I'd just go back to where I was in my 40s and not have health insurance. We're not in that position now.
ARDITI: Last October, her husband, Brad Lawrence (ph), got really sick, really fast.
BRAD LAWRENCE: I knew I was in trouble when I went into the emergency room, and I said, hi, I've gained 25 pounds in five days, and I'm having trouble breathing and my chest hurts. And they stopped blinking.
ARDITI: It turns out Brad had kidney disease. He was hospitalized for four days. He has to take an expensive new medication. Cynthia is now bartending down the street at the Lucky 13th Saloon. It brings in extra cash, but there's no benefits.
FREEMAN: It's one thing to have it as a little side gig. It's another thing to be looking at going into my 60s, and the best choice for me is getting a corporate job as a bartender at a hotel.
ARDITI: The price increases are pushing families to reassess their plans in all sorts of ways. Nicole Benisch (ph) in Rhode Island was going to marry her fiancé in the next month or so. But if they tie the knot, their household income would be too high to qualify for any financial assistance, and Benisch's premium would more than triple to over $700 a month.
NICOLE BENISCH: We have some tough decisions to make, and none of the options are really great for us.
ARDITI: For now, they've put their marriage plans on hold.
For NPR News, I'm Lynn Arditi in Providence, Rhode Island.
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