The Devastating Cost of Healthcare: A Family’s Story of Retirement Dreams and Rising Premiums

When Careful Planning Meets an Impossible System

Jean and Chaz Franklin did everything right. They followed the golden rule of retirement planning: “Pay yourself first.” Jean diligently saved hundreds of thousands of dollars throughout her career before becoming a stay-at-home mother at 41. Her husband Chaz, a former high school teacher, also planned carefully for their golden years. Their retirement vision was simple and achievable—living comfortably in their three-bedroom home in Colusa, California, about 60 miles northwest of Sacramento, where they raised their two sons. They envisioned traveling, pursuing hobbies like hiking and amateur photography, and enjoying the fruits of decades of responsible financial planning. But life, as it often does, had other plans that would test not just their savings but the very healthcare system they thought would support them through retirement.

A Health Crisis Meets a Healthcare Crisis

Early last year, everything changed for the Franklins when Jean, then 63, began experiencing alarming symptoms. She became unsteady on her feet, and one May morning, she woke up with slurred speech that landed her in the hospital. Her condition deteriorated rapidly as she lost the ability to move the right side of her body. While doctors worked to diagnose her mysterious illness, the couple received shocking news about their health insurance: their combined premium through the state insurance exchange would skyrocket from $540 per month to an astounding $3,899 per month starting January 1st. The reason was the expiration of enhanced federal premium subsidies that had been helping to offset their costs. The Franklins immediately canceled a monthlong cruise they’d planned with friends and began scrutinizing their retirement accounts, wondering if they could even afford to stay in their home. “Now, instead of thinking about where we can go in our retirement, we’re asking the question, ‘Are we still going to be able to stay where we are because of the health care costs?'” said Chaz, who had retired in 2021 at age 59.

An ALS Diagnosis Becomes a Bitter Financial Lifeline

In October, the Franklins received devastating news that would paradoxically provide some financial relief. Jean was diagnosed with ALS (amyotrophic lateral sclerosis), a debilitating disease that would eventually rob her of the ability to speak, swallow, or breathe on her own. This terrible diagnosis had one silver lining: it qualified Jean for Medicare immediately, rather than having to wait until age 65. The diagnosis saved them roughly $1,600 per month in premiums—a financial relief that felt hollow as Jean rapidly lost her ability to walk, bathe, and dress herself. Sitting in her wheelchair with a quilt draped over her legs to fight the intense chills that now plague her, Jean reflected on the morbid irony: “It’s kind of morbid that, because of my diagnosis, I got put on Medicare right away, so at least we don’t have to pay that out-of-pocket. We’re not going to get buried under this.” Still, their healthcare costs remain crushing. The $2,300 they now pay monthly—including Chaz’s premium and Jean’s Medicare supplemental insurance at roughly $342—exceeds their mortgage payment and consumes more than a quarter of their entire budget.

Millions Caught in the Subsidy Cliff

The Franklins represent just one family among 22 million Americans facing greater financial pressure after Congress chose not to extend the enhanced federal subsidies implemented in 2021. Those subsidies had been remarkably successful, more than doubling enrollment in Affordable Care Act (Obamacare) plans to over 24 million people. The Congressional Budget Office estimated that without extending these tax credits, the number of uninsured Americans would climb by 2.2 million in 2024 alone. By January, nationwide enrollment in ACA plans had already dropped by approximately 1.2 million year-over-year, though experts warn it could take months to understand the full impact as people miss payments and lose coverage. According to Stacey Pogue, a senior research fellow at the Center on Health Insurance Reforms at Georgetown University, the hardest-hit groups include early retirees, middle-income earners, and people living in high-cost states—all categories that describe the Franklins. “They fell off what we call a subsidy cliff,” Pogue explained. “It’s very, very shocking, the amount that a person would have to absorb.” The expanded tax credits had made the biggest difference for people nearing retirement age who sat just above previous income eligibility thresholds, and roughly half of those expected to lose premium tax credit eligibility were between ages 50 and 64.

The Political Debate Over Healthcare Subsidies

The political divide over healthcare subsidies reflects vastly different perspectives on government assistance and market incentives. Republicans who opposed extending the enhanced subsidies argued that the premium assistance went directly to insurance companies rather than consumers, creating incentives for fraud and wasteful coverage. They contended the subsidies were excessively generous, capping premium payments at 8.5% of income without any upper income limit for eligibility. U.S. Representative Ken Calvert, a California Republican who voted against an extension, wrote in an op-ed: “Most Americans would agree that taxpayers should not be subsidizing the health insurance of someone making $250,000. I cannot accept the simple extension of a program that will line the pockets of insurers and is riddled with fraud at the expense of the American taxpayer.” Patient advocates, however, paint a different picture of the consequences. Rebecca Kirsch, executive vice president of policy and programs at the National Patient Advocate Foundation, warns that premium increases force impossible choices: “The young people who are healthy are the first to say, I’m going to roll the dice” and forgo coverage. “Those who are remaining in the system—because they have no choice—are holding off care, they’re holding off their meds, they’re going without necessary food.”

Finding Strength in Family While Counting the Cost

Despite their financial challenges, the Franklins consider themselves fortunate compared to their neighbors. They have a nest egg to draw from, even if it means withdrawing $36,000 more than anticipated this year, mostly to cover Chaz’s insurance premiums. They’ve relied on their sons to help purchase a motorized recliner to assist with lifting Jean and a handicap van to transport her. Chaz has delayed fixing a tooth he broke a year ago because a crown would cost $1,000—a expense that now seems frivolous given their healthcare burden. “I have a nest egg,” Chaz said. “But there’s a lot of people around here who don’t.” For a while, Chaz was consumed by outrage at the political dysfunction that created this situation. “I wish Congress would get off their butts and solve this issue,” said Chaz, a registered Republican who blames both parties. “You’re so busy bickering over stupid crap and it’s both parties pointing fingers and blaming. Where was this discussion two years ago?” Now, he’s channeled his energy toward what matters most—making Jean as comfortable as possible during their remaining time together.

Before her illness, the couple did practically everything together: hiking, traveling, tai chi, amateur photography, and bug-hunting. Jean particularly loved finding rain beetles, fuzzy scarab-like insects that can’t feed as adults and rely solely on fat reserves from their larval stages. These days, Jean’s outdoor adventures rarely extend beyond being wheeled to the back patio to watch their backyard chickens. Each morning, Chaz and their sons Charlie and Louis take turns lifting Jean, dressing her, and helping her use the bathroom—tasks Jean jokes will eventually require therapy for her boys. Yet the family finds moments of joy and connection. Chaz’s stubbornness makes him an effective advocate for Jean’s care. Charlie seems to know exactly when his mother needs a big hug. Louis tells jokes that still make Jean snort with laughter. “I don’t know what I would do without my boys making me laugh,” she said. There’s a light at the end of the tunnel: in December, Chaz will turn 65 and qualify for Medicare himself, which should significantly reduce their premiums. “After this year—knock on wood—we should be OK,” Jean said, before pausing to shoot her husband a wry smile. “Well, you’re gonna be OK.” It’s the kind of dark humor that helps families survive impossible situations, a reminder that even amid financial stress and devastating illness, love and connection remain.