Shock, frustration for those losing ACA subsidies

Summary

Marketplace Morning Report

Episode: Shock, frustration for those losing ACA subsidies

Date: November 19, 2025
Host: Sabri Benishour (in for David Brancaccio)

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Episode Overview

This episode zeroes in on the sudden shock many Americans face as Affordable Care Act (ACA) subsidies and enhanced tax credits expire, resulting in significant health insurance premium hikes for millions. Through candid conversations, firsthand experiences, and expert advice, Marketplace explores personal impacts, the economics at play, and what options are left amid policy uncertainty.

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Key Discussion Points & Insights

1. Growing Internet Vulnerability (00:59 – 02:58)

• Cloudflare Outage: Sabri Benishour introduces a segment on a widespread internet outage due to problems at Cloudflare, underlining how much of the digital world depends on a handful of cybersecurity firms.
• Industry Concentration: Henry Epp explains how consolidation in cybersecurity means that single failures affect many global platforms (e.g., X, Shopify, Uber).
  • Quote: “The ripple effect is not just to one website or two. It's too many websites. And it's not just to one country. It's throughout the globe.” – JB Branch, Public Citizen (01:49)
• Risk/Reward for Businesses:
  • Outsourcing IT and cybersecurity is often financially rational (“It’s economies of scale.” – Kevin Cleary, 02:23), but introduces risks if those big providers go down.
  • The decision businesses face: accept the risk for lower cost and expertise, or absorb the higher cost of self-management.
  • Quote: “Do we want to roll the dice that every so often Cloudflare is going to have one of these issues?” – Kevin Cleary, paraphrased (02:45)

2. Japan–China Trade & Diplomatic Tension (02:58 – 03:57)

• Escalating Disputes: Recent comments by Japan’s new Prime Minister, suggesting a military response if China attacks Taiwan, triggered Chinese backlash.
• Trade Fallout: China retaliates with a renewed ban on Japanese seafood imports, just months after an earlier easing of restrictions.
  • Quote: “Diplomatic tensions are unlikely to ease anytime soon.” – Laura Bicker, BBC (03:53)
• Tourism Impact: China also warns its citizens against traveling to Japan, causing mass cancellations.

3. ACA Subsidy Expiration: Personal Impact (05:20 – 08:39)

The Shock of Rising Premiums

• Context: 24 million Americans buy insurance through the ACA Marketplace; many are now learning their plans will spike in price as pandemic-era subsidies expire and insurers raise rates (~25% increases).
  • “The cost of health insurance is going to double on average for people losing subsidies.” – Sabri Benishour (05:46)

Firsthand Story: Rebecca Wilson (06:06 – 06:56)

• Discovery: On the first day of open enrollment, Oregon resident Rebecca Wilson checks her 2025 rates.
  • Quote: “I put in all of our information, and I just started sobbing.” – Rebecca Wilson (06:16)
• Premium Increase: Her monthly premium jumps from $355 to $1,400.
  • Quote: “This is insane. It's just a couple hundred dollars less than my mortgage.” – Rebecca Wilson (06:28)
• Further Strain: Despite the drastic increase, deductibles remain high ($12k–$14k), plus copays and prescription costs.
  • Quote: “It's like I don't know how to do it anymore.” – Rebecca Wilson (06:56)

What to Do? Expert Guidance (07:10 – 08:13)

• Cynthia Cox, KFF: Advises consumers to plan as if the subsidies will expire.
  • Quote: “Maybe you'll be pleasantly surprised if something happens, but in the meantime, I think start planning as if they're going away.” – Cynthia Cox (07:24)
• Plan Flexibility: If Congress later extends subsidies, most can switch to better plans.
  • Quote: “It's pretty safe to assume that if Congress does extend the enhanced premium tax credits, you will be given a chance to come back in and take advantage.” – Sabrina Corlette, Georgetown (07:56)
• Get Help Early: Appointments with navigators or brokers will fill up, so act now to review options.
  • Quote: “You probably want to sign up for an appointment sooner rather than later.” – Sabrina Corlette (08:13)

No Good Choices, Only Necessity

• Prescription Reality: For people like Rebecca and her husband, going uninsured is not an actual choice.
  • Quote: “There's a couple of medications that we're both on that are really like, without insurance, they're just not affordable. Think over $1,000 a month. And ... they need them to live.” – Rebecca Wilson (08:32)

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Notable Quotes & Memorable Moments

• “I just started sobbing.” – Rebecca Wilson (06:16)
• “This is insane. It's just a couple hundred dollars less than my mortgage.” – Rebecca Wilson (06:28)
• “It's like I don't know how to do it anymore.” – Rebecca Wilson (06:56)
• “Maybe you'll be pleasantly surprised if something happens, but in the meantime, I think start planning as if they're going away.” – Cynthia Cox (07:24)
• “It's pretty safe to assume that if Congress does extend the enhanced premium tax credits, you will be given a chance to come back in and take advantage.” – Sabrina Corlette (07:56)

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Important Segment Timestamps

• Cloudflare/Internet Dependency: 00:59 – 02:58
• Japan–China Diplomatic/Economic Tension: 02:58 – 03:57
• ACA Subsidy Expiration Realities: 05:20 – 08:39

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Episode Flow & Tone

The episode maintains a brisk, matter-of-fact tone, blending urgent reporting with emotional, personal testimony. It offers practical insights and direct advice while letting frustration and anxiety speak for affected individuals – especially in the ACA segment. Marketplace's reporting strives for clarity and reassurance amid uncertainty, spotlighting both policy limitations and the lived reality for ordinary Americans caught in economic shifts.

Transcript

[Rebecca Wilson]

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[Marketplace Host]

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[Sabri Benishour]

The Internet is big. The number of companies making it run is small From Marketplace, I'm Sabri Benishore, in for David Brancaccio, ChatGPT, X, Shopify even the website for New Jersey Transit, among many other pages and apps, were not working for a few hours yesterday morning because of an outage at the company. Cloudflare, the cybersecurity firm, fixed the issue, but it is a reminder that a lot of the Internet relies on a small number of companies to keep things running, as Marketplace's Henry Epp reports, like.

[Henry Epp]

A lot of the tech sector, cybersecurity companies have grown in part by acquiring other companies, and those few firms protect lots of websites we use every day, says JB Branch with the consumer advocacy group Public Citizen. That means that when there's an outage like the one that hit Cloudflare this week week, the ripple effect is not just to one website or two. It's too many websites. And it's not just to one country. It's throughout the globe. There are reasons many global platforms Zoom or X or Uber rely on bigger cybersecurity firms, says Alan Woodward, a professor at the University of Surrey in the uk Especially if you're a big brand, you're a big name. You go for one of these bigger companies because they're the ones that can help you deal with things on a global scale. And a lot of companies and organizations have decided it's a better deal to pay another business to handle some of their IT needs rather than doing it all themselves, says Kevin Cleary at the University at Buffalo School of Management. It's economies of scale. At the end of the day, we can have a third party that can do it better than we can for cheaper than we can the trade off. Sometimes that third party has a problem. So Cleary says companies have to ask themselves, do we want to roll the.

[Expert/Analyst]

Dice that every so often Cloudflare is going to have one of these issues.

[Henry Epp]

Amazon is going to have one of these issues.

[Marketplace Host]

Microsoft is going to have one of these issues.

[Henry Epp]

A lot of businesses have decided that gamble is worth it. I'm Henry App for Marketplace.

[Sabri Benishour]

Things are getting more and more tense between Asia's two largest economies. That would be Japan and China. The latest escalation is that China has banned all imports of Japanese seafood. This all boils down to to Taiwan. Japan's new prime minister, Sana A. Takaichi, suggested her country could respond militarily if China attacked Taiwan. China brought up Japan's historical aggressions, and things just went downhill from there. The BBC's Laura Bicker reports from China.

[Expert/Analyst]

China is demanding that the Japanese prime minister retract her remarks or it says it will take further countermeasures. China has already urged its citizens not to travel to Japan, but resulting in mass cancellations. Beijing has now announced that it's reimposing a ban on seafood imports just months after it had eased restrictions put in place after Tokyo released treated wastewater from its Fukushima nuclear power plant. Diplomatic tensions are unlikely to ease anytime soon.

[Sabri Benishour]

That's Laura Baker there with the BBC.

[Marketplace Host]

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[Sabri Benishour]

Many of the 24 million people who buy health insurance through the Affordable Care Act Marketplace are discovering just how much more expensive their plans are going to get in the new year. Subsidies and Tax credits that have made these plans more affordable for the past few years are expiring. It looks like Congress will not renew them, but the future's cloudy. It could conceivably vote to extend the credits at the last minute. On top of all of that, health insurance companies that sell ACA plans are raising rates by about 25%. So you put that all together, and the cost of health insurance is going to double on average for people losing subsidies. So if you are about to buy health insurance, how do you plan for all that? Marketplace's Samantha Fields asked around.

[Samantha Fields]

On the first day of open enrollment, Rebecca Wilson woke up, grabbed her computer, and went straight to Oregon's Marketplace site to see what her health insurance was going to cost next year.

[Rebecca Wilson]

I put in all of our information, and I just started sobbing.

[Samantha Fields]

The plan she and her husband have now is going from $355 a month to $1,400 a month.

[Rebecca Wilson]

This is insane. This is insane. It's just a couple hundred dollars less than my mortgage.

[Samantha Fields]

Wilson and her husband are in their late 40s, and they're both freelancers. She's a former opera singer and voice professor who now does user experience design. He's a writer. Together, they make about $140,000 a year. With the enhanced subsidy they qualified for, they've been able to afford good coverage on the Marketplace for the past few years. Now they're not sure what to do with their premium quadrupling.

[Rebecca Wilson]

And to have our deductible still at, I think we're looking at, you know, another 12 to 14,000, plus your CO pays, plus your medication. It's like I don't know how to do it anymore.

[Samantha Fields]

For now, she's holding off on signing up for a plan just in case Congress does extend the subsidies or tax credits, though she doesn't really believe that'll happen. Cynthia Cox at the health policy nonprofit KFF says she gets it, but I.

[Expert/Analyst]

Would go ahead and plan as though the enhanced tax credits are expiring. Maybe you'll be pleasantly surprised if something happens, but in the meantime, I think start planning as if they're going away.

[Samantha Fields]

The question Wilson has is what happens if she does sign up for a plan now, maybe a worse but cheaper one, and then Congress votes to extend the subsidies after all.

[Rebecca Wilson]

I want to know if, like, I do, lock in, will I be able to have a chance to go back and redo it?

[Samantha Fields]

Both Cox and Sabrina Corlette at Georgetown center on health insurance Reforms say most likely, yes.

[Expert/Analyst]

It's pretty safe to assume that if Congress does extend the enhanced premium tax credits, you will be given a chance to come back in and take advantage, manage.

[Samantha Fields]

So Corlette says there's no reason to wait to sign up, especially if you might want help understanding your options.

[Expert/Analyst]

Appointments with people who are trained to help you, whether that's navigators or brokers, those tend to fill up quickly. So you probably want to sign up for an appointment sooner rather than later.

[Samantha Fields]

It doesn't feel like there are any good options to Rebecca Wilson, but she says she and her husband will have to find a way to make it work.

[Rebecca Wilson]

There's a couple of medications that we're both on that are really like, without insurance, they're just not affordable.

[Samantha Fields]

Think over $1,000 a month. And she says they need them to live. I'm Samantha Fields for Marketplace in New York.

[Sabri Benishour]

I'm Sabri Benishour with the Marketplace Morning Report. From apm, American Public Media.

[Expert/Analyst]

Imagine a future where chocolate and coffee are rare and expensive, where cheap nutritional staples like corn and wheat are threatened. Sounds unpleasant, doesn't it? Well, we could be heading there if we don't recognize that the climate crisis is also a food crisis.

[Sabri Benishour]

I've seen yields drop because of drought, and believe me, boy, have I seen them drop.

[Samantha Fields]

We have had dry spells that have lasted years.

[Expert/Analyst]

I'm Amy Scott. This season on How We Survive. We investigate how the climate crisis is threatening our most vital food systems and how scientists are racing to develop alternatives that will shape the future of food. Listen to this season of How We Survive on your favorite podcast. Apparently.