Stafford woman's premiums set to rise to $2,240 a month Stafford woman's premiums set to rise to $2,240 a month

The debate over the Affordable Care Act came down to one number for Barbie Smith of Stafford County: $2,240 a month.

On Thursday, the Senate rejected two bills to extend the federal subsidies that are set to expire Dec. 31. Unless the action comes up again before Congress leaves town for the holidays, Smith will pay $2,240 a month for her health insurance next year, compared to the $552 she currently pays.

The new amount is more than her mortgage and utilities combined, and it doesn't cover dental or vision. It also has an $11,000 deductible for each of the three people covered.

"What do you do? You either pay it and basically kill your income or get a part-time or full-time job, making far less money, with health care," she said. "Or I do what I'm sure millions are going to do and go without (insurance)."

Smith is a massage therapist, and her husband, Zack, is a professional musician. Both are self-employed, and like other small-business owners, qualify for ACA because they're not eligible for any type of group plan.

For months, the political debate has raged over whether to end or extend the federal subsidies that help make the coverage affordable for 400,000 people in Virginia and more than 20 million nationwide.

Legislation that would have extended the credits by three years failed in the Senate on Thursday by a 51-48 vote. It needed 60 votes to advance.

Republicans have described the tax credits the government pays toward the premiums as Obamacare "waste, fraud and abuse." Democrats say consumers will have no choice but to drop their coverage and seek treatment in emergency rooms, which will result in rising health care costs for everyone.

Stuck in the middle are people like Barbie Smith, whose American dream of running her own business is becoming the American nightmare of trying to find affordable health care.

"I'm willing to pay my share, even at $1,000 if I had to, but $2,300, that's crazy," she said.

She's 56, her husband is 61, and both are in good health, but "you just never know," she said.

Six years ago, the Smiths' older son Jacoby - a star golfer and musician and the valedictorian of Stafford High School's class of 2016 - suffered a rare stroke of the spine that left him paralyzed. He was 21.

He underwent months, and millions of dollars' worth, of medical treatments.

His mother recognizes the way a person's health can change in an instant, and, with her own mother in a long-term care facility, the costs associated.

Smith also acknowledges that it's been "awesome" to be a full-time massage therapist again, working in the former Purina Tower in downtown Fredericksburg. She rents a room from Green Fitness & Wellness owner Garrett Green.

The Stafford woman started Barbie Smith Massage Associates almost 26 years ago. Within two years of setting up her table, she had 16 therapists in the business with her.

Over the years, she's also worked as a physical education teacher in Stafford County Public Schools. The Smiths paid for their own health care insurance before Obamacare became available and continued until health plans changed and she would have had to switch carriers.

Instead of doing that, she opted to become a full-time teacher six years ago so she could get health benefits. She continued her massage work at night and every Saturday.

She saw the way the world changed after COVID-19 and decided in August not to go back to teaching.

"If you ask my No. 1 reason, I'm tired of being disrespected," she said.

She became a full-time massage therapist again and signed on, once more for ACA benefits. The premiums cost $552 per month, with the federal subsidy covering another $1,044.

Without the portion paid by the federal program in 2026, she'll pay the $522 premium and the government's former portion, which is rising to $1,688, for a total of $2,240 each month.

The Smiths started saving money months ago for the higher premiums and will stick with the more expensive plan for six months. If Congress hasn't come up with a solution before July 2026, she'll find another job with health benefits.

She knows plenty of people - electricians and plumbers, nail technicians and wait staff - will have to make similar decisions. She wonders if politicians, and the general public, realize the help the Affordable Care Act has provided for small-business owners.

"People think it's for those who aren't out there trying. I really think that's the true misconception," she said. "All my husband and I do is try to make people's lives better, and we're the ones that are going to get screwed in the end."