'Forgotten middle class': Some Delawareans face skyrocketing ACA premiums after enhanced tax credits expire

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Dave Roff and his wife Thea may be forced to pay $1,800 a month for her Obamacare insurance if Congress fails to extend enhanced plan subsidies that expired Dec. 31.

The Affordable Care Act open enrollment period ended this week. The sticker shock for health plans without the more generous tax credits mean some Delawareans are either choosing to pay skyrocketing premiums or go without coverage.

The Roffs said Thea was on a bronze plan last year, with a $280-a-month premium, which jumped to $450 this year. But Dave said that plan was too expensive for the limited medical access it provided. They chose a gold plan for this year that would cost $733 a month instead of $1,800 if Congress had extended the subsidies.

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Dave said he was taken aback when he first saw the higher prices.

"If the subsidies aren't extended, we're going to have to just go without insurance coverage," Dave said he initially thought. "And that's a frightening feeling when you have a partner who's going to have medical needs they need to be addressed."

But Dave said Thea must have health insurance due to several chronic health conditions. She's currently suffering from diabetic retinopathy, which is a complication from diabetes that damages blood vessels in the eye.

"She has to continue getting those treatments or she'll go blind," he said. "It's not the kind of thing that we can play with too much. We really have to have something in place for her."

'The forgotten middle class'

Congress passed the enhanced subsidies in 2021, allowing them to expire at the end of 2025 unless lawmakers extended them.

Some premium tax credits are still available, but the level of assistance has decreased for most enrollees. Consumers making above 400% of the poverty level — or around $63,000 per year for a single person — are now ineligible for the credits.

Dave, who is 70 years old, gets Medicare. But he said he must continue to work full-time so the couple can live. Thea, 63, is on disability due to several medical conditions, including depression and degenerative arthritis. She has a two-year wait to be eligible for Medicare.

"We're the 'forgotten middle class' just trying to make the best of a bad situation," Dave said. "You're too rich to get the help, and you're not poor enough to get all the free stuff."

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Congressional efforts to extend the subsidies

Democrats in Congress shut down the government for six weeks starting in late September in an unsuccessful attempt to force Republicans to agree to extend the enhanced tax credits.

Despite Republican House Speaker Mike Johnson's attempts to block such a vote, the House approved to extend the subsidies for another three years. Seventeen Republicans joined Democrats in supporting the legislation.

Delaware Congresswoman Sarah McBride says she hopes last week's vote will bode well for action in the U.S. Senate.

"I believe that any momentum is good momentum," she said. "And any progress is good progress to the ultimate goal of guaranteeing that Delawareans who cannot afford it do not see skyrocketing health care premiums."

However, the Senate is leaving town for 10 days and the chamber appears no closer to a bipartisan compromise than it has been in recent weeks. A spokesperson for Delaware Sen. Lisa Blunt Rochester said snags include anti-abortion activists pushing for new language restricting federal funding for abortions and adding additional income caps. In a statement, Blunt Rochester urged Senate Republicans to follow House Republicans' lead to lower health care costs.

"Across our nation, families are being forced to make impossible choices to try and afford their skyrocketing premiums," she said. "It's unacceptable."

ACA enrollment drops

According to numbers from the Centers for Medicare and Medicaid, 22.8 million Americans selected an Obamacare plan in 2026, a drop of about 1.5 million people from last year's 24.3 million sign-ups.

Each year, Westside Family Healthcare staff members act as navigators to help Delawareans who are eligible find ACA coverage. Tina Gaffney, associate director for enrollment services, said they've seen a 14% drop in enrollments this year.

Westside navigator Linda Domenech, who is assistant manager of enrollment services, said consumers who are still eligible for subsidies because they earn below 400% of the poverty level are also seeing premium prices increase, albeit by smaller percentages. She said clients saw, on average, individual premiums rise in the range of $100 to $200. But she said that increase could make the insurance completely out of reach for some Delawareans.

"We did have some families that were distraught over the increase," Domenech said. "We had people that were very, very concerned about the increase, concerned on how they were going to afford food, clothing, shelter, the basic necessities of living. So we had encounters like that, where the increases went up way more than they could afford."

Dave and Thea Roff said their daughter has generously offered to help pay the $1,800 premium for Thea's insurance, even if they'd rather not accept the money.

"We might have an option because of my daughter," he said. "If it weren't for her, I don't think we would."

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