Millions of Americans are beginning 2026 facing a significant increase in health care premiums, as COVID-era tax credits linked to the Affordable Care Act (ACA) expired at midnight on Thursday. This change has ended years of financial relief that helped keep premiums for marketplace plans relatively low. Experts from KFF, a health policy research organization, anticipate that some individuals may see their premiums rise by as much as 114%.
The impact of these changes is already being felt by small business owners in the Philadelphia suburbs. Sarah Cunningham, a wedding photographer based in Hatboro, Montgomery County, reported a startling increase in her health insurance costs. Last month, her premium was $35.79, but it surged to $112.96 in January—more than triple the previous amount.
Cunningham, who runs Sarah Anne Photography and earns approximately $55,000 annually, expressed her frustration over the rising costs. As a business owner without an employer to assist with health insurance payments, she finds herself scrutinizing her finances more than ever. She voiced her disappointment that Congress did not pass legislation to extend the subsidies for ACA plans, emphasizing the necessity for lawmakers to consider the struggles of middle and lower-class Americans.
To manage the escalating expenses, Cunningham is exploring ways to generate additional income. She plans to rent out her studio space to podcasters and fellow photographers and is contemplating returning to a gig economy job, such as Uber Eats. “About two years ago, I took up Uber Eats because you can clock on when you’re not busy and make a few bucks,” she shared, noting that the option is again on her mind.
Cunningham’s experience with a cervical cancer scare years ago has heightened her awareness of the importance of having health insurance. As grocery prices and car insurance costs continue to rise, she feels compelled to work more, as it may be her only avenue for financial stability. The pressures of balancing costs and providing for her 14-year-old son weigh heavily on her, illustrating the broader challenges facing many Americans grappling with rising health care premiums.
