After subsidies expire, skyrocketing health insurance premiums are here.

Stanton Ruese had long been planning for retirement. Those plans were forced to move up in timeline when, at 59, he was laid off by the Monterey Bay Aquarium at the outset of the Covid-19 pandemic, after building and maintaining exhibits there for 29 years.

During those years, Ruese had enrolled in health insurance through work. It was only after the layoffs that he went insurance shopping on Covered California, the state's exchange, established by the Affordable Care Act. "It was pretty seamless," he says.

He didn't even realize it at the time, but newly approved federal subsidies were helping to keep premiums low for customers just like him. It was an initiative approved by Congress due to the volume of people losing jobs and employer-provided health insurance.

"That allowed middle-income people to get help for the first time," Covered California Executive Director Jessica Altman says. "Covid was the catalyst to address affordability concerns that preexisted."

While the ACA had previously included tax credits for the poorest customers, the eligibility ceiling went up, meaning more affordable plans for people like Ruese. That contributed to a surge in enrollment. Nationally, the number of people enrolling in such plans more than doubled from 2020 to 2025, from 11 million to 24 million. In Monterey County, enrollment rose by 2,580 new enrollees, or 18 percent, to 15,970 people. Ruese, in Seaside, was one of them.

He'd already done some thinking about the cost of health insurance. He and his wife, Donna Penwell, got married in 2014 for health insurance, he says only half-joking. ("It saved me a lot of money," he says. Penwell adds: "My mom was happy.")

By the time Ruese lost his job, Penwell was newly enrolled in Medicare. He found he could afford decent insurance on Covered California – a silver plan provided some specialist coverage, crucial based on his history of skin cancer. Faced with rising costs, he later switched to Kaiser. But nothing prepared them for the spike they would see starting Jan. 1, when the federal subsidies expired, even though they had been closely tuning into the news about the standoff in Congress during the government shutdown. "The Democrats were asking for three years, and maybe would compromise for one year," Penwell recalls. "When they settled, I said, 'We're screwed.'"

"We are almost $1,000 poorer a month."

For Ruese to renew his silver plan, the monthly premium – what you pay just for the privilege of having insurance – would go from $381 to over $3,000.

"We did contemplate not going on insurance," Penwell says. "If we were in our 20s, we would – we couldn't at our age."

Instead, they opted for a bronze plan at $1,219 per month, with no specialist coverage until a high deductible is met. Ruese saw a dermatologist in December and is hoping to make it to his 65th birthday in October – marking Medicare eligibility – without needing to see a specialist.

The change took effect Jan. 1, and they are now looking to adjust their household budget. "We are almost $1,000 poorer a month this month," Penwell says. "I'm not exactly sure how we're going to do it."

They're reviewing TV streaming subscriptions, and will keep travel to just essential family visits, nixing hopes of going to Hawaii. Ruese is selling his motorcycle. There's always a chance their rent could go up.

They are careful to say they don't want sympathy – they are not poor, and are looking to shave luxuries from their life, not necessities. "We are very, very fortunate to be in the place we are in," Penwell says.

But middle-class people like them are in the worst position for this new world after the end of enhanced subsidies. Altman says, "The worst-case scenario is someone in their early pre-Medicare 60s who lives in a very high-cost region and makes just too much to earn the tax credit."

Ruese is just one of nearly 2 million Covered California patients facing premium spikes. He is frustrated by Congress' failure to protect people like him, a former Republican with libertarian leanings, who have worked and saved. He's written to U.S. Rep. Jimmy Panetta, D-Carmel Valley, but expects little to change. "I'm sure he gets thousands of letters like mine," Ruese says. "I am unfortunately just part of the masses."

SARA RUBIN is the Weekly's editor. Reach her at [email protected]