Data from the Kaiser Family Foundation shows close to 4 million people in the state are enrolled in the ACA Marketplace, like Yulissa Chavez from Galveston, who says she has multiple disabilities.
"My plan is going to increase, and I'm really concerned if I'm able to afford it," Chavez said. "There are certain medications that I need and certain services and providers. I'm worried I won't have as much access."
That fear is what many, not only in Texas, but across the country, are feeling.
Chavez says for her to get an affordable health insurance plan next year, Congress needs to extend ACA tax credits to help subsidize the amount people pay for their premiums, a debate that's at the center of the government shutdown.
"That was put in place under the ACA, and those were expanded in 2021 as part of a COVID response to help people afford healthcare, and that's the piece of it that's set to expire," Kathryn Anderson, an associate professor of sociology at the University of Houston, said.
Anderson said that if there's no extension for the expanded tax credits, there could be a surge in healthcare costs.
"In Texas at least, it's predicted to go up by 289%," Anderson said.
"I would then have to pay $508 a month, and if you make the count, that's a lump sum of about $1,500 a year, I would have to pay additionally," Chavez said.
She says a higher premium would mean cutting back elsewhere.
"People are having to choose between food, paying rent, and their health insurance," Chavez said.
If fewer people sign up for the ACA, industry experts warn that hospitals would have to bear the cost.
"That means when those people go to the hospital, they are unfunded, they don't have a payer helping them pay for the cost of their healthcare, so the hospital will have to eat the cost of their medical care," Lynn Cowles, a certified application counselor with the nonprofit, Every Texan, said.
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