Adrienne Martin and her family are starting the New Year off without healthcare.

The 47-year-old Texas mother had to make a difficult choice when she found out her monthly healthcare premium was increasing in 2026 from what she described as a manageable $630 (£467) to an unaffordable $2,400 (£1,781).

Her husband depends on an IV medication to treat a blood-clotting disease that costs $70,000 a month without insurance. Knowing their benefits would expire, the family stockpiled the drug to survive the first few months of the year.

"It would be like paying two mortgage payments," she said of the new monthly price for healthcare. "We can't pay $30,000 for insurance a year."

Ms Martin and her family are not the only ones facing this conundrum. Millions of Americans will see their healthcare bills skyrocket when these subsidies, which were provided through the Affordable Care Act (ACA), also known as Obamacare, expire.

Some members of Congress on both sides of the aisle attempted to extend these subsidies into 2026, but Washington was gridlocked. A vote in the new year could offer hope, but until then, many like Ms Martin will have to live without insurance or see their bills steeply increase.

About 24 million Americans buy health insurance through the ACA marketplace, and the majority were used to receiving tax credits to lower the monthly price.

Those tax credits, also referred to as subsidies, were first introduced through former President Barack Obama's ACA in 2014. They were then expanded during Covid.

The fight to extend the subsidies became the centre of the longest government shutdown in US history, which went on for more than 40 days earlier this year.

Democrats wanted to force Republicans to extend the subsidies for an additional three years, which would cost $35bn per year. Republicans did not want the government to foot the bill for another three years of subsidies without spending cuts.

The weeks-long shutdown - which left millions without essential government services - ended when a group of Democratic senators agreed to reopen the government, if Republicans in the Senate agreed to vote on extending the subsidies.

But that vote still hasn't happened yet, despite efforts from Democrats and four Republicans to put the issue to Congress before the subsidies expired.

"I am pissed for the American people," New York Congressman Mike Lawler, a Republican who pushed to save the subsidies, said. "Everybody has a responsibility to serve their district, to their constituents. You know what is funny? Three-quarters of people on Obamacare are in states Donald Trump won."

Without the subsidies, the monthly cost of healthcare could rise by 114% on average, according to health research non-profit KFF.

Maddie Bannister is among the Americans bracing for that.

The California mother, who just had her second child, was paying $124 a month for her family of three in 2025. Now, with a new baby and no ACA subsidies, she is preparing to pay $908 a month.

"So many people are going to choose to be uninsured because it's cheaper to pay a penalty for being uninsured than it is to have healthcare," she said.

For Ms Bannister's family, the increased cost of healthcare means putting off other spending: "We were saving for a home, and saving money for that is going to take way longer if we have to spend $11,000 a year on healthcare that we barely use."

While Ms Bannister is stomaching her new bill, and Ms Martin is going without healthcare, others are resorting to different government programmes to get their coverage.

For years, Stephanie Petersen used Medicaid - a healthcare program for lower-income Americans - to get healthcare coverage. Just recently, she was able to switch and get her coverage through the ACA – a welcome change for the 38-year-old.

Because her health care is skyrocketing from $75 to $580 a month, she is returning to Medicaid coverage in the New Year.

"I'm trying to stay optimistic but the way things have been going, I'm not hopeful," the Illinois resident said. "Everyone should have affordable, good healthcare, and not have to jump through all these hoops."

A vote on the three-year extension of the ACA subsidies is now expected the week of 5 January when Congress returns to Washington.

Until then, Ms Martin will be one of the more than 27 million Americans without health insurance in 2026.

A number that is likely to grow, experts warn, as healthcare costs increase.

"We're not low-income people, we make decent money, but we can't afford $30,000 a year for insurance, that's crazy," she said.

"We've done everything we're supposed to do, we've worked our whole lives, we work hard, and we just get screwed. The whole system is a nightmare." (BBC)

• PHOTO: Adrienne Martin faced a difficult choice after her monthly healthcare premium increased dramatically. PHOTO: Adrienne Martin.

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