As the January health insurance deadline looms

Correspondent

Texas Metro News

DALLAS – After the long American government shutdown this past year, many people were hit with the idea of higher health insurance premiums than ever before.

This will be due to the fact the government, on both sides of the aisle, has done little to work for the people on this issue in the past year.

The rates are increasing primarily because enhanced Affordable Care Act (ACA) subsidies that lowered costs during the pandemic are expiring, leading to much steeper out-of-pocket costs for millions on the marketplace.

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Add to that general increases from rising medical/pharmacy costs and you have a recipe for disaster.

One notable expiration includes the Enhanced ACA subsidies implemented during COVID-19, now ending. This means enrollees lose substantial financial help, making benchmark plans much more expensive.

There has also been a rise in healthcare costs overall and some are blaming labor shortages, although it obviously goes much deeper.

If you are going to go the route of the ACA be sure and review your options during open enrollment, which ends on January 15 for coverage to begin February 1.

Inquire as to what financial help you qualify for in 2026, as state subsidies might offer some relief.

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Use HealthCare.gov (or your state's marketplace) during this open enrollment to compare plans and see your actual subsidy amount for 2026.

In November Congresswoman Julie Johnson (TX-32) who leads the New Democrat Coalition's Health Care Access and Affordability Task Force hosted a healthcare roundtable at Texas Health Presbyterian Hospital Dallas. The roundtable included over two dozen hospital executives, medical associations, and community health leaders. The idea was to discuss issues affecting healthcare in North Texas.

Johnson said "The cost of care shouldn't decide who lives and who dies. When premiums double and hospitals close, it's working families and seniors who pay the price. Texas is home to world-class healthcare talent — but it's time Washington gave them the tools to match their commitment to care."

It does not seem that Johnson's words or the meeting was heard, so as an individual you might want to take a deep dive into other insurance options.

Remember, if there are health insurance lobbyists making sure their companies get more money, the American people are not getting what they deserve.

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Lately, some physicians have gone the route of no longer taking health insurance. Instead, they are having patients pay individually through credit or a substantially lower payment plan than health insurance companies (i.e., deductibles or more) offer.

Look into a direct health care provider https://www.goodrx.com/insurance/alternative/direct-primary-care charging patients a recurring fee for direct, membership-based access to primary care services, and bypassing traditional insurance for routine visits and often more serious issues too.

A medical professional working under the direct healthcare provider model normally charges patients not only the abovementioned fee, but patients receive more personalized and accessible care with a lower patient-to-provider ratio.

Examples of services include annual check-ups, including lab work; urgent care needs and routine visits; chronic disease management; minor procedures like laceration repair; and telemedicine services.

There is also a focus on preventive care, wellness, and building a long-term relationship with the patient and most DPC practices are not subject to the regulations of traditional insurance plans. Healthcare companies do not take patients seriously even denying claims to the point of death. So, if you cannot beat them at their game do the next best thing to make these companies irrelevant in your game because you do not need them anymore.

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With the increasing costs of healthcare and the way our government managed it this past year, visit

https://www.opensecrets.org/industries/summary?cycle=All&ind=F09&recipdetail=M&sortorder=U and see if you can put the pieces together as related to lobbyist groups and PACS, which are possibly one of the reasons health insurance rates are increasing and the American people are losing.

The numbers below are reported from 1990 to 2024 and are the top 20 member recipients of money from insurance lobbyists/PACS.

Joe Biden (D) $8,232,278

Mitt Romney (R-UT) $7,774,719

Kamala Harris (D) $6,742,939

Hillary Clinton (D-NY) $5,544,472

Barack Obama (D) $5,525,204

John McCain (R-AZ) $4,177,409

Richard Neal (D-MA) $3,637,976

Mitch McConnell (R-KY) $3,361,725

Charles Schumer (D-NY) 2,998,119

Chris Dodd (D-CT) $2,658,254

John Larson (D-CT) $2,565,589

John Boehner (R-OH) $2,517,784

Paul Ryan (R-WI) $2,516,145

Rob Portman (R-OH) $2,437,029

Tim Scott (R-SC) $2,236,972

Earl Pomeroy (D-ND) $2,178,445

Patrick McHenry (R-NC) $2,172,279

David Perdue (R-GA) $2,149,604

Bernie Sanders (I-VT) $2,138,289

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