They're uninsured after Obamacare became too costly. And they're far from alone.

Key Points:

• Ross and Rebecca Tobiassen from North Carolina canceled their ACA health insurance after monthly premiums surged from $130 to over $550 following the expiration of enhanced tax credits at the end of 2025.
• The couple, small business owners, are among millions expected to drop ACA coverage due to rising costs after subsidies established during the COVID-19 pandemic expired, with enrollment potentially falling from over 22 million to as low as 16.5 million in 2026.
• North Carolina saw a 22% drop in ACA signups for 2026, the largest decline among states, reflecting widespread unaffordability despite the critical need for coverage among workers in hazardous jobs and those with chronic illnesses.
• Health experts warn that as healthier individuals leave ACA plans, the risk pool worsens, potentially causing premiums to rise further in a "death spiral," while subsidies to keep plans affordable would impose significant costs on taxpayers.
• The Tobiassens have no plans to return to ACA coverage and are relying on savings, credit cards, or family support in case of medical emergencies, illustrating the tough choices many Americans face amid rising healthcare costs.