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Legislation to renew Affordable Care Act subsidies is now heading to the Senate. The House passed the bill on Thursday over the objections of Republican leadership. Millions of people have already signed up to pay much higher premiums when those subsidies expired at the end of last year. Other people dropped their health plans altogether. And the search for insurance is causing some to make dramatic changes to their lives. Here's NPR's Selena Simmons-Duffin.
SELENA SIMMONS-DUFFIN, BYLINE: For Ken Warner, the dramatic life change is searching for a full-time job with benefits after years as an independent author.
KEN WARNER: My heart is in epic fantasy, like, you know, "The Lord Of The Rings." The series I have that has done the best is actually an alien invasion sci-fi series.
SIMMONS-DUFFIN: He and his wife are in their mid-50s and live in Manchester, Connecticut. His wife is also self-employed.
WARNER: She's a therapist in private practice.
SIMMONS-DUFFIN: Last year, their health plan from the Affordable Care Act marketplace had a premium of $630 per month. This year, without the enhanced federal subsidies...
WARNER: It's about $2,500 a month, which is just insane. I mean, that's just criminal. Like, we can't afford that. Who can afford that? That's another salary, basically.
SIMMONS-DUFFIN: Warner says they need another option, so he's looking for a job with an employer-sponsored health plan.
WARNER: It's hard. It's hard. You know, my resume basically says, 10 years as a indie author. Who wants to hire that, you know? So I don't know what we're going to do, to be honest with you.
SIMMONS-DUFFIN: In Morgantown, West Virginia, Shannon Waliser was facing a $2,800 monthly premium for herself and her husband.
SHANNON WALISER: We just don't have that type of money to spend on health insurance for a high-deductible plan, so we don't have health insurance.
SIMMONS-DUFFIN: She canceled their ACA plan. She'll pay out of pocket for her medications and to see a specialist. She'll use a direct primary care practice. She's also considering using what's called a health share, where members pool resources to help with expenses in the case of an accident or another calamity. It's an option that lacks the full legal protections of health insurance.
WALISER: You know, my husband and I are active, and we take care of ourselves and are very mindful of what we eat and our lifestyle. So if something happens, it happens. We have no control over that.
SIMMONS-DUFFIN: Waliser is a mental health provider who runs a small business. She says her five employees are also dealing with the higher premiums for these plans.
WALISER: One of my employees got married.
SIMMONS-DUFFIN: If you marry someone with health insurance through their job, you can often get on their employer-sponsored health plan. It's a way to sidestep the ACA without getting a new job - if you have someone you want to marry.
WALISER: Another employee - their parent is helping with their premiums. And, like, they're young, so their premiums are lower.
SIMMONS-DUFFIN: Waliser says if Congress comes to a deal on the enhanced subsidies, she'd be happy to get her old plan back. Ken Warner and his wife are also hoping federal lawmakers do something.
WARNER: But, you know, obviously, we're not going to hold our breath waiting for that.
SIMMONS-DUFFIN: He says both he and his wife have health conditions they need coverage for, so they already paid $2,500 for January's premium. He's hoping a new job with benefits or maybe a deal in Congress to restore the enhanced subsidies will spare them from paying that much in the months to come.
Selena Simmons-Duffin, NPR News, Washington.
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