A Boring Dystopia

I'm co-opting your comment, so apologies if you don't approve.

It's a bit of both, opting and forced. At this point, I've commented in dozens of threads about my personal situation, so apologies to those folks who are seeing yet another comment with the same sentiment from me.

In a nutshell, I was laid off this year due to the Trump administration, due to a variety of factors I have not returned to work, and I'm using the ACA for health insurance. While I still have several days to make a final decision, I can see an argument for classifying my situation as "opting for no coverage" versus being forced.

Here's the thing, in my entire adult life, health insurance has always cost me more than it saved me. Literally, 2025 is the very first year where I might have broken even, and that was only because I had an unexpected health emergency.

On top of that, when you're unemployed and in a financially strained situation, being 1 million dollars in debt is pretty much the same as being 10 thousand dollars in debt. Can't repay either. So, having health insurance with a maximum out of pocket is still no guarantee that I won't end up in financial ruin.

More importantly, the degree to which health care costs are going up this year is unprecedented for a lot of people. The raw, unsubsidized cost of ACA plans is increasing close to 50%. Bronze plans (lowest) cost as much as silver plans did for 2025, silver plans cost as much as gold plans. In addition, all the out of pocket expenditures are increasing like copays, coinsurance, deductibles, and maximum out of pocket. But that's not all, the cost of prescriptions and medical costs in general are increasing due to inflation, so even if the insurance is 100% comparable to last year, we're still paying much more. The final and often the most significant blow is that these tax credits / incentives are going away. These were significant, they made the lower tier plans free for those most in need and provided significant relief for people earning up to around $60,000. All combined, the cost increases associated with these plans is honestly absurd. Truly a WHAT THE FUCK situation.

Even if we all agreed that this is how it needs to be, no sensible and reasonable policy would let this all happen at once. At a minimum, these increases and changes should have been phased in slowly enough to allow people to adapt and there should have been much more communication that this was on the horizon. I say that, because after I was laid off this year, I was directed towards an ACA plan (versus COBRA coverage, if you don't know what that is, just know that it's expensive and limited) with no mention of this time bomb about to explode. That's a major failure on all fronts.

So, apologies continue, this ended up being yet another novel on the subject. But it's important that people know how terrible and complicated this situation is.

In summary (i.e. the TLDR) is that I could probably afford the very cheapest and shittiest plans offered through the ACA for 2026, but at the end of the day I have to look at the risk versus the cost, and realistically, the case could be made that if I choose not to get a plan, I'd be opting for no coverage versus being forced. Not that my situation is the norm, but I'm also sure I'm not the only person in the USA in this kind of predicament.