Doctors Go Uninsured Amid Rising Premiums

Joshua and Ashley Durham, who operate a family medicine practice in Boise, Idaho, find themselves without health insurance for their own family for the first time. After their monthly premiums on the ACA marketplace increased by several hundred dollars to nearly $1,600 this year, they opted to pay medical expenses out-of-pocket using their health savings account.

Nationwide, while a larger percentage of healthcare workers have insurance compared to the general adult population, many are still feeling the strain of rising costs. Projections indicate a 8.2 percent jump in employer costs for 2027. This trend is partly attributed to the expiration of pandemic-era ACA marketplace credits, which had previously reduced premium payments for many, particularly those in small businesses.

These rising costs are making health insurance untenable for small medical practices. Without affordable options, some employers may consider alternatives like higher wages or minimal plans. The expiration of expanded ACA subsidies and projected cuts are expected to increase the number of uninsured individuals by approximately 15 million over the next decade.

This situation creates a cycle where healthier individuals opt out of insurance, leaving insurers to cover a sicker, more expensive pool of enrollees, thereby driving up prices. Samantha LeGault, a nurse practitioner in Boise, faces similar challenges, with her family's monthly premiums jumping from $700 to $1,500, forcing her to cut back on other expenses like dental insurance and prioritize public school for her children.

Some healthcare professionals, like retired executive Jill Kordick, remain insured due to the devastating financial consequences of medical events they've witnessed. However, even she experienced a significant premium increase from $75 to $800 monthly after subsidies expired, leading her to delay medical care for a sinus infection and implement cost-saving measures at home.

The Durhams have also observed the impact on their patients, sometimes forgiving medical bills for those struggling financially. Joshua Durham is particularly anxious about being uninsured, recalling his parents' struggles with medical debt. He, like some other healthcare providers, sometimes exchanges services for care, receiving free eye exams in return for primary care services.