Jim Dana: Jingle all away

EDITOR'S NOTE: The views and opinions expressed are those of the writer and not of Ottawa News Network.

That’s not a typo, nor did I misremember the lyrics. This is not a Christmas column.

December was the month when citizens had to re-enroll for their Medicare or Affordable Care Act policies. So that was me, singing to the sound of coin tumbling from my bank account into the maw of the health care system. It is not a merry tune.

We’re a two-policy family. I’m retired and have Medicare, while my wife and daughter are covered through the Affordable Care Act.

The deadline for Medicare was Dec. 7. I rolled my policies over. The combined cost of Medicare and my Medigap policy for 2026 will be $5,114, an increase of $457, or 9.8%. High, but manageable.

The ACA is another story. The deadline for my wife’s plan was Dec. 15, but it was not clear until the last minute what the cost would be. Would Congress restore the enhanced premium tax cuts that had been in place since the COVID-19 pandemic? Or would it stick with their elimination, which was mandated by the “One Big Beautiful Bill” passed last summer?

When, on Dec. 11, the Republicans shot down the Democratic proposal to extend the subsidies for three more years and the Democrats, with a few Republicans, shot down the feeble Republican proposal not to extend subsidies but instead to deposit $1,000 per person in Health Savings Accounts, it became clear:

We were Scrooged!

In 2025, my wife’s low deductible-high premium plan cost us $640 a month, $7,680 for the year. The same plan for 2026 would cost us $1,043 per month, or $12,512 for the year, a whopping $4,832 (63%) more!

We are not — not yet — among the reported 59% of Americans who would find an unexpected $1,000 expense “a problem.” We could even pay the $5,000 — once. But this kind of increase on a regular basis is unsustainable for us and many, many other Americans.

It’s estimated that the loss of the enhanced tax credits will cause 2.2 million people to drop their insurance altogether, while the remaining 30 million ACA policyholders will see huge increases in their premiums. It’s life-changing, in a bad way.

Our choices

We had the option of rolling over our existing plan or choosing a different, mid-level (silver) plan, but that, too, was a big increase — $3,809 per year. Ultimately, we chose a bronze — also called “catastrophic” — plan. That is, a low premium, high-deductible plan.

Our premium will be $363 a month, or $4,356 a year, lower than in 2025! But we’ll essentially be paying all of our medical bills until we reach the deductible, which is $9,600 each for my wife and daughter. We reached that decision with the help of a “health sherpa” — who knew there was such a thing? — because it’s very difficult to weigh all the variables of premiums vs. deductibles, co-pays, co-insurance, and MOOP (Maximum Out Of Pocket) costs among the many different plans.

Are we comfortable with the decision? Not really. Proponents of the Byzantine health insurance business might say we made the decision as “informed consumers.” But what it really did was turn us into gamblers. We had to make a decision, and this seemed marginally the right one. We have been pretty healthy over the years.

Finally, we made the bet that we will remain so for 2026 and that our actual medical expenses will be less than the difference between the policy premiums. But of course, that could turn out to be wrong.

Now, rather than putting the decision behind us with a sense of calm and security, we live with the clenched gut and pinched perspective of precarity.

It doesn’t need to be this way

The cause of the dramatic premium increases for the Affordable Care Act policies is clear: the One Big Beautiful Bill passed by the Republican Congress this summer extended tax cuts for the rich, but eliminated the enhanced premium tax cuts that helped keep the ACA plans affordable.

The ACA tax cuts would have cost an estimated $350 billion over 10 years, while the tax cuts for the rich will cost an estimated $2.7 trillion! In 2027 alone, the approximately 1,000 billionaires in the U.S. will receive $125 billion of those cuts. In other words, in less than three years, the proposed tax cuts for 1,000 rich people will exceed the cost of the ACA’s enhanced premium tax cuts for the whole 10 years. Do the billionaires really need them? 

You can see what the Republican priorities currently are and what a grotesque imbalance there is. I’d say a balancing of the ledger is in order.

I mentioned earlier that our family opted for the “catastrophic” policy. We usually think of catastrophes as resulting from natural disasters or unforeseeable accidents. But this is an unnatural disaster. It’s volitional, avoidable, and entirely the making of an out-of-touch Congress led by a billionaire president who claims “affordability is a hoax.”

The catastrophe could still be averted now that Congress is back in session. The easiest — and most honest — way would be to simply restore the enhanced premium tax cuts for two or three years to give legislators time to craft reasonable and effective fixes to our whole system.

Let’s hope they do. Otherwise, millions and millions of citizens will be like me — mad as hell.

— James Dana resides in Grand Haven.

How to submit an opinion

Ottawa News Network accepts columns and letters to the editor from everyone. Letters should be about 300 words and columns should not exceed 1,000 words. ONN reserves the right to fact-check submissions as well as edit for length, clarity and grammar. Please send submissions to newsroom@ottawanewsnetwork.org.