Single Mom Stunned as ACA Insurance Jumps $159—Will She Lose Her Coverage?

Natalie Richards, a single mother and dishwasher at Chili's, is grappling with a staggering increase in her health insurance premium, which shot up from $3 to $164 a month in January. This sudden spike is a crushing blow to her already tight budget, as she struggles to cover rent, groceries, and other essentials. Like millions of Americans, Richards relies on the Affordable Care Act (ACA) marketplace since her job does not provide health insurance. With this steep premium hike, she fears losing her medical coverage entirely.

"It's life or death," Richards, 37, told Business Insider. "And beyond that, it's quality of life. I could be completely miserable and struggle for everything. Or, when I have my meds, I can look at problems, see the bigger picture, and figure it out."

Richards has faced challenges securing employer-sponsored health coverage throughout her career, which has included roles in nonprofits and hospitality. The ACA has been a lifeline, allowing her to afford medications and therapy sessions to manage her ADHD, a condition she describes as debilitating without proper care.

This year, millions of individuals like Richards have lost access to enhanced ACA subsidies—government credits aimed at helping low- and middle-income households afford healthcare. These subsidies, expanded during the COVID-19 pandemic, expired on December 31, 2022, following a prolonged standoff in Congress over their renewal. As a result, enrollment in the ACA marketplace dropped by 1.4 million in January, with further declines anticipated in the coming months. Early 2025 saw around 24 million people enrolled in ACA plans, a number that had risen steadily since the enhanced subsidies were introduced in 2021. Richards's plan, which rolled over from the previous year, is expected to lapse soon due to unpaid premiums.

"The things I desperately need right now, I don't have access to," Richards lamented. "This is probably the hardest time in my life."

Healthcare is not Richards's primary spending priority, as her monthly earnings are slightly above minimum wage. She must allocate her income to basic necessities, including housing, utilities, and food. Lacking a car, she relies on limited public transportation options in her small city of Palestine, Texas, making it difficult to travel between work and appointments. With her current financial constraints, even a doctor's visit is simply out of reach.

"I've been in crisis mode," she reflected, noting that she has resorted to home remedies for any potential illness or injury and has skipped refilling her most recent prescriptions.

Unfortunately, Richards's options for health insurance extend beyond the ACA, as she does not qualify for Texas Medicaid, which is limited to low-income children, pregnant women, seniors, and individuals with disabilities. Texas is among the ten states that did not expand Medicaid under the ACA, leaving residents like Richards without viable alternatives. Her part-time job does not offer an insurance plan, and while she is actively seeking a new role with stable benefits, she has faced challenges in securing such opportunities.

What worries Richards the most is the potential loss of mental health support. Allowing her marketplace plan to lapse would mean losing regular access to her therapists and the medications essential for her everyday functioning. Furthermore, as she shares custody of her teenagers with their father, Richards fears that losing her healthcare coverage jeopardizes her ability to effectively manage both her mental and physical health, which in turn affects her role as a parent.

"I'm losing the ability to document that I am the capable parent that I say that I am," Richards explained. "It's my stability, my capacity, my credibility—it's all at risk as a direct result of not having healthcare."

The challenges faced by Natalie Richards are reflective of a larger crisis affecting many Americans in the wake of subsidy expiration. As healthcare costs continue to rise and access to affordable plans becomes more limited, individuals like Richards are left to navigate a precarious landscape where their health and well-being hang in the balance. Without renewed support and options, the future looks uncertain for millions relying on the ACA for essential healthcare needs.