Name: ACA保費上漲的無聲後果！ (The Quiet Fallout From Higher ACA Premiums)
Uploaded: 2026-02-26T05:01:18.000Z
Duration: 5 min 13 s

分詞構句

More than a million fewer people have signed up for ACA Marketplace health coverage so far in 2026, compared with last year.

截至 2026 年，報名參加 ACA Marketplace 健康保險的人數比去年少了超過一百萬。

That's the first time enrollment appears to have fallen since 2020.

這是自 2020 年以來，報名人數首次出現下降。

基礎被動語態

I spoke with several people who were forced to make a choice between a more expensive plan and taking a risk.

我採訪了幾位被迫要在更貴的保險計劃和冒險之間做選擇的人。

And it really only comes down to one of three choices.

First, they could drop their health insurance entirely.

第一種是，他們可以完全取消健康保險。

Robin and her husband, who run a small business together in Ohio, chose this route.

羅賓和她的丈夫在俄亥俄州經營一家小型企業，他們就選擇了這條路。

Dropping our health insurance was a significant decision for us.

ترك健康保險對我們來說是個重大的決定。

So I'm enrolled because of how expensive it was this year.

所以我報名是因為今年的保費太貴了。

My son is currently enrolled in the ACA market, and

我兒子目前在 ACA 市場註冊，而且

I, myself, and my spouse have opted not to enroll.

我自己和我的配偶選擇不註冊。

Robin's family was paying about $750 per month in 2025 for coverage to cover herself, her husband, and

羅賓一家人在 2025 年為她、她的丈夫和他們的孩子支付了每月約 750 美元的保險費用。

However, to keep that same plan in 2026, their premium would have risen to nearly $1,000 a month.

然而，要在 2026 年繼續使用相同的保險計劃，他們的保費將上漲到每月近 1,000 美元。

They were already considering switching plans because she felt her existing coverage didn't provide access to many doctors.

她們已經在考慮更換保險計劃，因為她覺得現有的保險範圍無法讓她們看很多醫生。

What we decided was to say, we'll take what we were putting toward the premium last year and just set it aside each month so that if medical issues arise, we can pull from that pot.

我們決定是說，我們就把去年付的保費存起來，每個月撥出一部分，這樣如果發生醫療問題，我們就可以從那筆錢裡拿出來用。

Now, keep in mind, the average premium payments for subsidized enrollees who keep the same plan have more than doubled, from an average of $888 in 2025 and to $1904 in 2026.

現在請注意，領取補助而選擇維持相同保險計劃的註冊者，平均保費支付金額已翻倍以上，從 2025 年的平均 888 美元漲到 2026 年的 1904 美元。

And considering nearly half of Americans said they live paycheck to paycheck in 2024, odds are they can't afford this expense.

考慮到 2024 年近半數的美國人表示他們是月光族，他們很可能無法負擔這筆費用。

We had to kind of make a calculation because we can't just, like, pull 300 extra dollars out of our butt.

我們必須做個計算，因為我們不能像變魔術一樣，憑空拿出額外的 300 美元。

We made the calculation of, like, well, we can't be paying this much every month, but

我們計算了一下，嗯，我們不能每個月付這麼多錢，但是

hopefully we won't have to, like, go to the hospital.

希望我們不用，像是，去醫院。

This brings us to the next option Americans have, which is to downgrade their plan.

這就帶到了美國人下一個可以選擇的方案，就是降級保險計劃。

Last year, Kate and her husband were enrolled in a mid tier plan known as the Silver Plan on the Marketplace, and

去年，凱特和她先生在 ACA Marketplace 上註冊了一個中等級別計劃，叫做銀級計劃，

Their overall deductible was $0 from medical care and $1,500 for prescriptions.

他們的整體自付額是醫療照護 0 美元，處方藥 1,500 美元。

However, after the enhanced subsidies expired, they downgraded to a Brown's plan, which provides less coverage.

不過，在強化補助到期後，他們降級到布朗計劃，這提供了較少的保險範圍。

Their monthly premium rose to about $157.

他們每個月的保費漲到大約 157 美元。

The trade off was a much higher deductible of roughly $15,000.

取捨的結果是自付額大幅提高到約 15,000 美元。

I just worry because nobody knows what's going to happen.

我只是擔心，因為沒人知道接下來會發生什麼事。

Nobody knows if they're going to get in, like a car accident or, you know, something comes out of left field so that if there is an emergency, you're not going into debt for the rest of your life.

沒人知道會不會發生像車禍，或是意想不到的突發狀況，這樣如果真的有緊急情況，你才不會是以負債一輩子。

Finally, the last option is to keep their existing coverage and pay more.

最後一個選項是維持現有的保險範圍，然後多付錢。

I spoke with Nancy Lender in Georgia, who declined to appear on camera, but

我訪問了喬治亞州的 Nancy Lender，她不願露臉，但

she told me that she decided she absolutely needed insurance, even though her Premium tripled from $162 in 2025 to about $483 this year.

她告訴我，她決定絕對需要保險，即使她的保費從 2025 年的 162 美元，漲到今年的約 483 美元。

Nancy, who's 47 years old, has regular visits with a roster of doctors due to a host of medical issues that include complications from a brain tumor.

47 歲的 Nancy 因為腦瘤併發症等許多醫療問題，需要定期看醫生。

Nancy and her husband realize that they're going to have to budget more just because they have to stomach much higher costs for health care premiums.

Nancy 和她的丈夫意識到，他們必須增加預算，因為他們得忍受更高的健康保險保費。

now pick fast food rather than a sit down restaurant.

現在選擇速食店，而不是餐廳。

They won't be taking a vacation this year.

Nancy told me she really misses vacations.

There really aren't that many options other than the ACA for people who do not qualify for insurance outside of employment.

對於那些無法透過工作獲得保險的人來說，除了 ACA Marketplace 之外，選擇真的不多。

Kate told me the cost of health insurance has also made her rethink something bigger, whether she can afford to keep doing the work that she loves.

Kate 告訴我，健康保險的費用也讓她重新思考一件大事，那就是她是否還能負擔繼續做她熱愛的工作。

Is there going to be a point in time where, like, I need to just stop doing this and I have to get a different job?

會不會有那麼一天，我必須停止做這件事，然後找一份不同的工作？

My husband is kind of like potentially going to go that route?

我先生是不是也有可能走上那條路？

We're not exactly sure yet because also the job market is a total nightmare right now.

我們還不太確定，因為現在的就業市場也很糟糕。

So it almost even feels like that's a risk too financially is like switching to something else.

所以，換到別的工作聽起來反而像是一種財務上的風險。

Because if you're gonna try to get a better job where you're making good money and, like, you have all the benefits and stuff, like, you probably have to get trained, you know, to do something like that and who knows how long that training will be and what does it cost and all this stuff.

因為如果你想找一份薪水不錯、福利又好的好工作，你可能需要接受訓練，你也不知道訓練要多久、要花多少錢等等。

I feel like it's really easy to get trapped.

Interestingly, red states are the ones most affected by this issue.

有趣的是，受這個問題影響最大的反而是那些「紅州」。

More than 3 in 4 ACA Marketplace enrollees in 2025 live in states won by President Trump in the last election.

2025 年，超過四分之三的 ACA Marketplace 註冊者居住在上次總統大選川普贏下的州。

In those states, 80% of all premium tax credits nationwide, about $115 billion went to enrollees in those Trump won states.

在這些州，全美約 80% 的保費稅收抵免，約 1150 億美元，都給了這些川普贏下州的註冊者。

Some pundits feel the issue could swing the outcome of upcoming midterm elections.

有些評論家認為這個議題可能會影響即將到來的中期選舉結果。

Two out of three Americans say they're worried about the ability to pay for health care more than any other household necessity.

三分之二的美國人表示，他們對支付健康照護費用的擔憂，勝過其他任何家庭必需品。

This puts health costs squarely in focus at a time when pollsters say affordability will be a central theme of the election cycle.

這使得健康照護費用成為焦點，而民調顯示可負擔性將是這次選舉週期的主要議題。