When ACA Health Insurance Premiums Rise, Moral Distress Rises Too

Yesterday, we paid our January premium for our ACA health insurance plan.

It was more than four times our December premium.

At the same time, we now have one fewer eligible family member on the plan—and higher out-of-pocket costs.

Less insurance.
At four times the price.

After more than a decade on my employer’s health plan, my wife and I knew that the transition from W-2 employment to running our own business would come with a learning curve. We expected complexity. We expected paperwork.

What we didn’t expect was how quickly health insurance costs would climb to a level that made me seriously wonder:

Would we actually be better off with no insurance at all? Just going fully self-pay?

That question alone should give us pause.

Still, I don’t want to spend my time simply bemoaning my own increased costs—or even the skyrocketing health insurance premiums facing millions of Americans right now. I don’t want to pin this on one political party or another.

And I don’t even want to repeat the well-worn (and true) statement that the United States is the only high-income country where people routinely fear financial collapse when they get sick or injured.

I won’t retell the story of my teenage daughter worrying aloud about money while we were on the phone with 911 during a health crisis.

Even though all of that is real.

Why I’m Most Concerned About Healthcare Workers

The group I’m most worried about right now isn’t small business owners like me.

It’s healthcare workers.

Why?

Because healthcare professionals enter this work with a clear purpose: to provide excellent care for their patients.

But that purpose is increasingly undermined when:

• A patient says, “I can’t afford that test. I’ll have to pay for it all out of pocket.”

• A cancer patient has to stop working and can’t find an affordable option for immediate health coverage.

• Someone delays care altogether, terrified of the ambulance bill or the emergency room charge.

In moments like these, delivering excellent care can feel nearly impossible.

This is where moral distress takes hold.

One of the most powerful antidotes to healthcare worker burnout is the belief that your work is making a difference. That your effort matters. That the system allows you to help.

Rising healthcare and insurance costs are steadily pushing that antidote out of reach.

The hearts of healthcare providers are breaking—not because they don’t care, but because they care deeply and can see what’s coming. They know that people who need coverage will lose it. They know patients will delay care. They know outcomes will suffer.

And they’re being asked to carry that weight every day.

P.S. Thanks to Dan Sherman for a recent session that helped illuminate just how significant this coming increase in moral distress may be.