Pennsylvania bike shop owner John Ronca has been buying health insurance through the Affordable Care Act marketplace for over a decade. Last year, with enhanced ACA tax credits enacted under the Biden administration, the premiums for his gold plan—the second-highest tier, which includes lower deductibles and often more flexibility in seeing specialists—tripled. Ronca decided to go for a bronze plan with a higher deductible to make sure he, his wife, and his young daughter were still insured. Now he’s putting off surgery for carpal tunnel syndrome because he can’t afford to pay for it in full. His family’s combined deductible is $14,000.

“I was really hoping to have that taken care of, but with the new deductible and the new plan, I’m pretty much pushing that off,” Ronca told me, “and owning the bike shop, my hands are my money makers.”

“If Congress had to have a Bronze ACA plan…it would change immediately.”

Americans are facing an affordability crisis, and health care........

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