Jen S.: From the Classroom to the Coverage Gap

Jen S., a former teacher in Arizona, has always prioritized staying insured and maintaining her health. She grew up with a mother who was a nurse, and for most of her life she had stable employer-sponsored coverage through her teaching job. That stability began to unravel after she left the classroom.

Jen had taught in her local public school for 11 years, but when she transitioned into contract work for education nonprofits and advocacy organizations, she lost access to employer benefits. She and her husband turned to the ACA marketplace, paying roughly $650 a month for coverage. Their income was high enough that they didn’t qualify for subsidies, even though they were “right on the cusp,” Jen explained.

Now, premiums for plans comparable to their current one are projected to jump from around $650 per month to about $970, an increase of nearly 50%. As both Jen and her husband self-employed, they have no access to employer-sponsored insurance and few alternatives. Their choices have narrowed dramatically. As Jen put it, “Really the options are, we pay this higher premium for what’s already a bronze plan, besides catastrophic coverage, or we’re just completely uninsured. I’m afraid to do that, but that’s the decision that we’re facing.”

The timing couldn’t be worse. In 2024, Jen’s health changed suddenly. She experienced a series of medical issues requiring emergency care, specialist visits, and ongoing treatment. “For the first time ever, we maxed out our out-of-pocket max and our high deductible. We’re still trying to cover the cost of the medical debt that accrued over the past year,” Jen said. Because she cannot take paid time off, each appointment also meant lost income. “The health issues have caused a lot of income loss that makes it harder to pay for the medical bills and to consider paying for premium increases.”

Just as they were trying to stabilize their finances, another blow arrived. Their insurer, Banner Aetna, announced it would no longer offer marketplace plans after 2025. This forces Jen and her husband to switch insurers entirely, and none of the remaining options include all her current providers in-network. After a year requiring coordinated, specialized care, the disruption feels especially alarming.

The idea of going without coverage is terrifying to her. “This is the first time in my life potentially that I am not covered,” she said. She has always valued preventive care and worries about what will happen if the cost of coverage forces her to delay or avoid treatment. After a year filled with medical uncertainty, the stakes feel even higher. “Preventive care is so important,” she emphasized. “Last year, I really needed the insurance, so I’m afraid that if some other health issue happens, I can’t afford to pay out-of-pocket.”

Jen and her husband are also considering whether having children is even an option, which adds another layer of stress. Even without a pregnancy, next year’s premiums alone “would cost us so much more.” Meanwhile, the medical debt from the past year continues to strain their budget.

Jen’s experience reflects a growing reality for families across the country. Premium increases are determining whether people can stay insured, seek preventive care, start a family, or recover financially after illness. She hopes policymakers understand what is at stake. Rising premiums and shrinking plan options are reshaping people’s lives, and for Jen, the choices are becoming harder every day.