How the GOP plans to replace Obamacare!!!

As insurers retreat from Obamacare, a working family is caught in the squeeze.

Story by Peter Whoriskey

JACKSON HOLE, Wyoming — Like millions of other Americans, Stacy Newton turns to Healthcare.gov to shop for health insurance for her family. The Affordable Care Act website, according to the government, is where consumers are supposed to find “a menu of health insurance plans.”

But for the Newtons and many others in the country, next year’s menu is severely limited: There is only one company offering ACA plans here — and costs have risen steeply.

To continue health coverage for themselves and their two teenage children, the Newtons would have to pay an annual premium of $43,000 — about a third of their gross income.

It is the price of the cheapest plan available to the family from Blue Cross Blue Shield of Wyoming, the only ACA insurer left in Teton County. This year, millions of American families that have relied on ACA, popularly known as Obamacare, are being squeezed on multiple sides: Premiums are rising, the covid-era subsidies that helped pay for those policies are shrinking, and there are fewer choices with insurers pulling out of some markets.

The squeeze here is a symptom of broader trouble in American health care. In western Wyoming and other regions, the expected rollback of enhanced subsidies has destabilized the economics of Obamacare, pushing some insurers to retreat from the government-supported market because it won’t be profitable.

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That is leaving consumers like the Newtons with little choice but to buy a pricey, unsubsidized policy from a local monopoly.

Next year, the number of counties with only one company providing Obamacare will jump from 72 to 146, according the Robert Wood Johnson Foundation. That number is expected to rise further if, as appears likely, Congress fails to renew the enhanced subsidies.

Newton and her husband, Derek, each run a small business — she is an independent sales representative, and he outfits vans — and like many entrepreneurs, they have relied on the ACA for health insurance. But this year, the price of their policy rose 34 percent, and the federal subsidy that helped them pay for it is slated to go away. At the same time, they know they will need medical care: Last year, Newton, 51, was diagnosed with chronic leukemia.

“It’s terrifying,” she said. “We’re not rich, we’re not poor. We’re a standard, middle-class family, and somehow now I can’t afford health insurance.”

This year, the enhanced subsidies that helped middle-income people afford Obamacare plans have been stuck in partisan congressional deadlock. The subsidies expire Dec. 31, and Republicans, who hold the majority, have opposed extending them.

Anticipating that sticker shock will induce healthy people to drop out of insurance and saddle health plans with a higher proportion of the sickest, costliest patients, insurers say they must dramatically raise ACA prices or pull out of Obamacare marketplaces altogether.

Without the enhanced subsidies, “I would expect more insurers to retreat, to exit,” said Katherine Hempstead, a senior policy officer at the Robert Wood Johnson Foundation. “People will see less choice and higher prices.”

According to economic studies conducted in 2017 and 2018, another turbulent period when Obamacare insurers faced losses and political uncertainty, prices rose between 30 and 50 percent when an area was reduced to only one ACA insurer.

How Obamacare Failed the America People – Search Videos

The problem here in Teton County began in August when the only other insurer providing ACA coverage, Mountain Health Co-op, announced it was pulling out, citing the looming expiration of the enhanced subsidies. Of the roughly 46,000 people on Obamacare in Wyoming, about 11,000 are expected to drop coverage, according to insurers.

“The basic problem with reducing the subsidies is that healthier people say ‘we can’t afford insurance’ and drop out, while the sicker population are, like, ‘oh, my god, I still need it,’” said Alexander Muromcew, a board member of the Mountain Health Co-op. “As an insurer, you end up with a smaller and higher-risk membership, which is not sustainable.”

Muromcew said competition had been good for consumers, noting that when Mountain Health entered the market here a few years ago, Blue Cross Blue Shield dropped its prices. Now, as a monopoly, he said, Blue Cross Blue Shield has more power to dictate prices.

“Without competition, I worry that it’ll be easier for Blue Cross Blue Shield to raise rates even further,” Muromcew said.

Diane Gore, president and chief executive of Blue Cross Blue Shield of Wyoming, said she understands the frustration of people getting hit with rising premiums and lowered subsidies.

“I get it, I completely get it,” Gore said.

The company says its prices are the same across most of Wyoming, regardless of whether there is a competitor. Gore attributed this year’s price hikes, which she said were 25 percent on average, to the expectation that the remaining Obamacare customers will be sicker, and to the rising cost of medical care in rural areas, where health care providers are scarce and competition is often limited. Of every premium dollar the company collected last year, she said, 95 cents went to direct medical care.

Insurance companies don’t always find Obamacare markets profitable. Aetna, one of the largest insurance companies, announced earlier this year that it was dropping ACA coverage in 11 of 15 states. The move affected about a million Obamacare customers.

As medication costs rise, decreasing insurance coverage has deadly consequences

“I understand that there is rhetoric from the Beltway that the insurance companies are getting rich off of Obamacare,” Gore said. “But that’s not this insurer in Wyoming.”

Many people in this resort town are seasonal workers, self-employed or small-business entrepreneurs. Lacking employer insurance plans, they have come to rely on Obamacare. Among them, the anxiety is widespread.

“Clearly, the system is broken,” said Heather Huhn, an insurance broker in Jackson.

On her desk, she has a stack of files with the applications for about 30 families that she calls the “Hold Tight” pile. They are mainly people who have ongoing medical needs, such as chronic conditions or expensive prescriptions, and can’t afford to pay for health insurance at the current costs. For weeks, she said, they have been desperately waiting to see whether the government will extend the enhanced subsidies that began during the pandemic.

“They sit across from my desk and say, ‘I just don’t know what to do,’” Huhn said. “I tell them not to have a mental breakdown just yet. People are having to suffer because the government can’t figure out how to fix it.”

Sophia Schwartz, a professional skier and health care administrator here, senses similar apprehension. For years, she has been inviting groups of “ski friends,” many of whom have irregular jobs, over for dinner to counsel them on how to get health insurance.

“This was the scariest year I’ve ever done it,” said Schwartz, a former member of the U.S. ski team and now a big-mountain skier. “People came to me in pure panic.”

Considering ‘BearCare’ and other options

In desperation, many are turning to stopgap measures.

Some, especially skiers, were looking at policies at a company called Spot Insurance that cover reimbursement of medical bills incurred after accidents on the slopes. Others were looking at “healthshare” groups in which members contribute monthly to cover each other’s eligible medical bills; among the drawbacks of these programs is that elective surgeries and nonemergency treatments may not be covered.

And some were considering “short-term” insurance policies. Those are closer to conventional health insurance, but those insurers may reject applicants with medical conditions such as diabetes, heart disease or cancer.

With many in Wyoming searching for answers, even the state is jumping in.

State officials have proposed “a major medical plan” they have called “BearCare.” The policies would, at “a significantly lower price,” cover emergency situations such as “being attacked by a bear” and other more common medical catastrophes.

It would not cover ongoing or chronic medical needs. Some of those looking for conventional health insurance say the state proposal is woefully inadequate. “I don’t worry about being bitten by a bear, I worry about getting cancer,” said Margie Lynch, 58, an energy efficiency consultant based here.

For the cheapest Obamacare plan, she would have to pay $1,585 a month. Its benefits would not kick in until she paid a deductible of $10,600. “The cost of the premium is almost as much as my mortgage,” Lynch said.

“I’m lucky enough to be able to pay for it if I have to. But there are so many people out there who won’t be able to.” Newton, Lynch and others here have shared their concerns with Wyoming’s representatives in Congress: Sen. John Barrasso, Sen. Cynthia Lummis and Rep. Harriet Hageman. All three Republican lawmakers have opposed Obamacare and criticized Democrats, who have pushed to extend the enhanced subsidies.

Margie Lynch at Snow King Ski Resort in Jackson, Wyoming.

“Stacy’s story and experience is one of the many heartbreaking examples of how Obamacare has failed families across Wyoming,” a statement from Barrasso said. “Instead of working with Republicans to make health care more affordable for all Americans, Democrats would rather use more taxpayer dollars to bail out Obamacare and hide its failures.”

A spokesman for Lummis said, “The health care problem Americans are facing is a direct result of the Democrats’ failed Affordable Care Act — Sen. Lummis had the foresight to oppose this misguided legislation from day one.”

A spokesperson for Hageman said in a statement that “Rep. Hageman knows there are many people struggling with the weight of medical expenses, and the catastrophic failure of Obamacare is making it far worse.”

The squeeze

For years, Obamacare had worked well for the Newtons.

In 2017, when the couple were starting their businesses, their income was low — about $56,000. The price of their policy was $1,585 per month, but the standard ACA subsidy covered most of that, and the couple had to come up with only $332 monthly.

Since then, however, the prices of the premiums have risen steadily, and now, because of the expected subsidy reductions, they would no longer qualify for government help. They would have to pay full price — $3,573 monthly for the cheapest option. Even at $43,000 a year, the plan carries a $21,200 deductible, according to the paperwork Stacy Newton showed The Post.

Earlier this month, the couple struggled with whether to pay that to Blue Cross Blue Shield of Wyoming, go without health insurance or find some other stopgap option. Newton was getting notices that said, in bold red lettering: “Important — You’re about to end (terminate) this coverage. If any of the people above get health care services or supplies after 12/31/2025, they’ll have to pay full cost.”

Eventually, Newton knows she will need leukemia treatment. She’s just not sure when. “If my leukemia acts up, I’m up a creek,” she said earlier this month. “I just don’t have a solution yet.” On Monday, she sent a text. “I just officially canceled my ACA marketplace insurance for 2026,” she wrote.

“How on earth is this going to unfold for millions of people in America?

******

They keep saying “gross income,” but the ACA uses MAGI. – Search
Under the Affordable Care Act, eligibility for Medicaid, premium subsidies, and cost-sharing reductions is based on modified adjusted gross income (MAGI). MAGI is after certain deductions. Self‑employed people can legally lower MAGI with retirement contributions, business deductions, HSAs, etc. The article never mentions this.

Rural markets are expensive for reasons the article barely touches. Low population, hospital monopolies, and no insurer competition = high premiums. 

That’s not new, and it’s not unique to Wyoming.
ACA subsidies are based on income. If your income goes down, your subsidy goes up. If your income goes up, your subsidy shrinks. There are still subsidies, but not for people who make $130,000 annually. The article never explains this, which makes the whole situation look more mysterious than it is.

The problem is that most of us who don’t have multiple children are being forced to pay these “subsidies”. If Obamacare worked, it would not need subsidies to survive. A single person with no children has outrageous premiums, extremely high deductibles and has to pay for 1/2 of any procedures performed.

Not quite: All insurance pools involve cross‑subsidies, like employer plans, Medicare, private plans, and ACA plans. Healthy people subsidize sick people; low‑risk subsidizes high‑risk. That’s not an ACA invention, that’s literally how risk pooling functions.
ACA subsidies aren’t funded by “people with no kids.” 

They’re funded through federal tax policy. 

Your premium doesn’t go up because someone else gets a subsidy; your premium goes up because your local market has high medical costs, low population density, and little insurer competition. The same structural issues the article describes.

And high premiums for single adults aren’t proof ACA “doesn’t work.” They’re proof that your region’s underlying medical prices are high. Your insurer has monopoly pricing power, and/or you’re not eligible for income‑based subsidies.

Geez, perhaps we should explore a single payer system like the REST OF THE WORLD’S developed countries? We don’t have a health care problem. We have a health care INSURANCE problem. For profit insurance is the problem. By LAW they only have to pay 80% of premium dollars for actual care. 

Insurance companies eat 20% of premium dollars as admin costs and profit… Medicare operates on a 5-7% cost basis, so that’s a 13-15% savings right there… (but that can’t happen because health care insurance companies donate massive amounts of money to elect people that won’t change that math.)

The Affordable Care Act was never affordable. It was a myth that was touted as being the “great savior” for all Americans. Looking back on this and seeing who pushed for this we now know who to blame for the prices today. The American people were lied to. Time to strip away all the liars and cheats that inhabit Congress.

I found it very affordable. Considering the alternative would be nothing because of my pre-existing and terminal medical condition.  Maga thinks people with preexisting conditions should do the patriotic thing and just die. 

If TRUMP gets his way then every employer will tell the staff sorry we don’t offer healthcare anymore.

. Will tell me where they can go for affordable healthcare? 

But yet it’s democrats that push for legalized suicide

The Gallup poll conducted in 2024 found that 71% of Americans support legalized euthanasia, while 66% support legalizing doctor-assisted suicide. Support goes way beyond one party. Remember, the dems are the ones that came up with this plan to pay health insurance companies billions of taxpayers dollars.

The cost of Healthcare and associated insurance is a rip off. A four day stay in the hospital can easily cost 40,000 dollars. That is the first rip off. The second rip off is the cost of insurance. With OBAMACARE, The government is required through supplemental payments to line the insurance Co. pockets and erase the force of supply and demand.

Stop the supplemental payments and prices of health care and insurance will come down.

Hospitals are a rip off, I pay 75 dollars every month as I refuse to pay more, I still owe them over 1500 dollars so I called again to pay the 75 dollars we agreed on. Then they said if you pay the whole amount, ( and I wanted to yell at him) but i said I can offer you 40% discount, so I agreed to do that. ~Anonymous statement

Eliminate the ACA and healthcare costs will drop? 

Eliminate the ACA and millions of Americans will be without healthcare. Think that’s a good thing?

The ACA was only affordable to those who couldn’t afford health insurance and only used by those who have significant health conditions and most are pre-existing. Let’s call it as it is” If you are covering insurance for 30 million Americans, and your greater than 50% of your plan participants require medical work exceeding $10,000 a year—you lose. 

If you have insurance, you are likely to use it. That’s only the beginning. By subsidizing it, you now rely on taxpayers to fund it and guess what: More claims, illnesses, surgeries, etc..

It’s a vicious cycle. Lastly, employers provided insurance also impacted. Pre-existing conditions. More, cost, higher premiums and stupidly, they now follow the ACA on MAX out pockets and no lifetime benefit caps. The whole thing has ballooned. It’s not the insurance companies…it’s everybody else using it for one illness to another. 

Our nation has been consumed with Diabetes, Heart Disease. Cancer, Autism, and other illnesses.  The United States spends more per capita on health care than any other country in the world. Still, Americans tend to live shorter, less healthy lives than those in most other wealthy, highly-developed countries.

While the United States lags behind other similar countries in key outcome measures, some American communities at the local level stand out for having exceptionally healthy populations, as reflected in both objective and self-reported indicators. The Unhealthiest Versus 34 of the healthiest counties in America.

People are getting diagnosed, screened, and guess what, your doctor finds more to treat. More bills. Therefore, we want better nutritional guidelines so our food chains are less toxic. We want agnostic vaccine vetting–we want better scrutiny of our over-the-counter meds like Tylenol. 

There is so much we can do to reduce our medical conditions, but the crazy Dems get in the way every single time. The Government would have it their way. We would allow Americans one visit per year and cover 50% of all medical costs up to $10k.

Which is a lot and let America work making itself healthy again.

Hit The Root Cause Not a Hard Problem to Solve!!!

If you think the republicans care about our healthcare and the Democrats are the bad guys you could not be more wrong. Both parties have it all wrong. Open your eyes.  “One visit per year and covering 50% of all medical costs up to $10k” is a recipe for massive numbers of medical bankruptcies and premature deaths.

Don’t get sick. It’s not hard. Follow the HHS guideline. RFK Jr. is putting out an amazing program. There are other programs such as access to crowd sourcing and assistance on setting up go-fund-me accounts. We really want to reward the ones who stay healthy. 

We voted on this last year, remember?

Those work,,but the crooked and corrupt hate Trump media will never report that America has become disengaged with our own creators and sought to rely on formulas and equations as opposed to the power of going to Church and praying. Sad

The Quintessential Bohemian lifestyle – Search is characterized by a rejection of conventional societal norms and a focus on artistic expression. Key figures in this movement include Paul Bowles, Janis Joplin, and Jack Kerouac, who embody the spirit of nonconformity and creativity. The term “bohemian” originally referred to the Romani people and later evolved to describe artists and intellectuals who lived freely and creatively, often in urban artistic communities. Today, bohemian style is marked by flowing fabrics, vibrant patterns, and a sense of self-expression, often seen at music festivals and cultural events.

Healthcare costs in America consume some 17% of our GDP. 

In countries with universal healthcare (and there are multiple variations on how that is provided) healthcare consumes 6 to 8% of their GDP and their overall health outcomes are better than in America. Our system is set up to reward the insurance companies and other intermediaries at the cost of American consumer’s bank accounts and their health.

The US has unparalleled healthcare resources–money, medical facilities, and healthcare professionals–to provide the best medical care in the world to our citizens, ALL of our citizens. Instead, we have a class system in which the well-to-do actually do get the best care in the world and the rest of us get whatever we can afford. The ultimate measure of success is the average age of mortality, and we lag behind the rest of the developed world. 

Why? Because the money goes to greedy healthcare insurance companies, drug companies, for-profit hospitals, and doctors. The solution has been obvious for decades: a single-payer system with the power to negotiate prices and salaries. Obamacare never worked. It merely hid the real cost of the program through taxpayer funded subsidies.

Be careful what you wish for, you may just get it.  It’s past time for America to have a national healthcare plan for all. Uncle $am is big enough to get rid of the greedy insurance vultures that pick our bones dry.  Look at Canada and the UK. I don’t want to wait for a year or 6 months if it is discovered that I have cancer or other deadly disease.

My current insurer dropped out of Obamacare so I have to go to a new plan now. It is what it is.  It seems to me that the government bends over backwards so that insurance companies can make as much money as they want.  The epic selfishness and greed have eclipsed the original reason for the flood….pray for Messiah to come quickly in our time….

How so? Undocumented people don’t get Obamacare, they don’t get Medicaid, they do get emergency life saving emergency care. Just like every citizen would. Doctors are funny like that.. They don’t just let people die because they don’t have insurance.. … and yet they give free health care to those that have no right to be here. 

Why should the rest of America’s working people have to help pay for Their Insurance.   Because that’s what insurance is. A SHARED risk pool… Only thing wrong with healthcare in this country is the stupid government meddling

As insurers retreat from Obamacare, a working family is caught in the squeeze  

A massive political earthquake just hit Washington after the U.S. Government Accountability Office (GAO) released a stunning report revealing more than $21 BILLION in Obamacare-related fraud in a single year, with long-term estimates reaching a staggering $60 BILLION in taxpayer losses. This explosive revelation has triggered panic inside the Democratic Party, furious debate in Congress, and an outraged public demanding answers. For years, critics warned that the program lacked sufficient oversight and verification safeguards. Now, with the GAO’s findings out in the open, Americans across the country are demanding real solutions, transparency, and accountability for massive taxpayer losses.

In this video, we break down:

🔥 The GAO’s bombshell findings — what the report actually uncovered

🔥 How billions in fraud slipped through the system

🔥 Why critics say Obamacare oversight “collapsed”

🔥 How Democrats are responding to the report

🔥 Why this scandal is triggering national outrage

🔥 The political battle now unfolding in Congress

🔥 What this means for the future of Obamacare

🔥 What reforms Americans are demanding moving forward This is one of the biggest government waste stories in years, and the fallout is only beginning.

👉 Watch until the end — the final numbers will leave you stunned.