Unless Congress acts in the next month, up to four million Americans are expected to become uninsured, because they can no longer afford their health insurance premiums.

While Congress has finally reached a deal to end the longest government shutdown on record, during which Democrats pressed Republicans to lower people’s health insurance costs, Democrats relented without a compromise that would avert the country’s imminent health care policy catastrophe. The two sides now need to agree on a deal to prevent the millions of Americans who purchase health insurance through the Affordable Care Act’s marketplaces from facing an average 30 percent premium hike next year.

Key takeaways from our interviews with the new uninsured

• Vox spoke with a group of people from a variety of backgrounds — a young gig worker, a father and husband, an early retiree, and a middle-aged entrepreneur — who are facing extremely difficult choices as their health care costs climb.
• They could be forced to take shortcuts on their health: skipping appointments, stockpiling medicines, and possibly going uninsured altogether.
• They feel the politicians who could fix this for them are more worried about scoring political points than fixing the US health system.

If lawmakers don’t act, health insurance premiums are poised to climb five or six times what some policyholders paid just last year.

More than 20 million people buy insurance on the marketplaces, and now, many are experiencing sticker shock as they realize their insurance options are much more expensive or that they have lost all of their assistance and are completely priced out of medical coverage.

Democrats have forced Republicans to agree to a vote on restoring people’s health insurance subsidies by mid-December as a condition of ending the shutdown. Bipartisan negotiations are happening in the House and Senate to figure out a deal to reauthorize the subsidies and bring down costs.

But lawmakers are running out of time; open enrollment for coverage ends on December 15. To understand the human stakes of these policy negotiations, I spoke with four people who are facing significant ACA premium hikes and are now considering going uninsured.

The contractor

Hussein Cabrera, 45, is, ironically enough, an IT........

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