Healthcare Workers Feel the Pinch as Insurance Costs Soar, Iowa Retiree Shares Struggle

As health insurance premiums continue to climb across the nation, even the people who work in healthcare are feeling the financial strain. A new report highlights how doctors, nurses, and other medical professionals are making difficult choices about their own coverage, and one Iowa woman's story shows just how widespread the problem has become.

Why are healthcare workers going without insurance?

The rising cost of health insurance is pushing some medical professionals to make a surprising choice: going without coverage altogether. Joshua and Ashley Durham, who run a family medicine practice in Boise, Idaho, decided to drop their insurance plan after their monthly premiums jumped to nearly $1,600. Instead, they are paying out-of-pocket and relying on their health savings account.

While healthcare workers are traditionally more likely to have insurance than other professions, the trend is shifting. Nationwide, 7% of healthcare workers were uninsured in 2024, compared with 11% of all adults under 65, according to a KFF analysis. Even doctors, who are usually the most likely to maintain coverage, are now facing tough decisions.

Employers are bracing for an additional 8.2% jump in costs for 2027, making the situation even more challenging for small practices and independent medical offices.

What caused the latest premium increases?

The expiration of pandemic-era Affordable Care Act marketplace credits has played a major role in the recent spike. The Republican-led Congress opted not to renew those credits last year. While subsidies remain for low-income individuals, many middle-class families and small business owners have lost their financial cushion.

Nearly half of marketplace enrollees in 2024 worked for small businesses or were self-employed, including many in chiropractic care and dentistry. Jack Dillon, executive director of the Association for Independent Medicine, said the premium increases have become untenable for small businesses.

“The cost has become so astronomical. You're looking at it and saying, 'What's the value?'” Dillon said.

The Congressional Budget Office projects that the number of uninsured Americans will grow by roughly 15 million over the next decade due to the subsidy expiration and cuts from the One Big Beautiful Bill Act.

An Iowa perspective: One retiree's struggle

Jill Kordick, a 64-year-old retired healthcare executive from Norwalk, Iowa, knows this struggle all too well. She is counting down the 16 months until she becomes eligible for Medicare at age 65, but the wait is proving costly.

Last year, Kordick qualified for enhanced ACA tax credits, allowing her to pay just $75 a month for coverage. When those subsidies expired, her premiums shot up to $800 a month. With a $10,000 deductible, she delayed treatment for a sinus infection until it became an ear infection.

Kordick said she now regularly rethinks nonessential grocery purchases and keeps her thermostat at 80 degrees in the summer to save on air conditioning. Despite her decades of experience in healthcare, she said the system is failing even those who know it best.

“It's disheartening that it's as broken and fragmented as it is,” Kordick said.

How are healthcare workers coping with high costs?

Some healthcare professionals are finding creative ways to manage. The Durhams, for example, pay $420 monthly toward their physician assistant's premiums. Two other employees receive coverage through their spouses.

As a primary care physician, Joshua Durham said he can diagnose and treat himself and his family, though the American Medical Association's code of ethics generally discourages this practice. Arthur Caplan, a bioethicist at NYU, said the changing landscape may warrant revisiting those guidelines as more people turn to relatives for care.

Others, like nurse practitioner Samantha LeGault, have no choice but to pay. Her family's premium rose from $700 to $1,500 a month, consuming about one-fifth of her income. She has cut retirement savings, switched her children to public school, and skipped dental insurance to make ends meet.

For healthcare workers without advanced medical training, the options are even more limited. Many lack the savings or the ability to self-treat, leaving them vulnerable to the same financial pressures as their patients.

What does this mean for Iowa families?

The trend of rising premiums and shrinking coverage options is hitting Iowa families hard. As more people opt out of insurance, the risk pool shrinks and becomes sicker, which drives prices even higher. This cycle puts pressure on everyone, from independent medical practices to families trying to balance their budgets.

For the Durhams, the decision to go uninsured has paid off so far. They have spent about $9,000 out-of-pocket this year, still less than what their premiums would have cost. But Joshua Durham remains nervous about the future.

“Do I have pancreatic cancer today?” Durham said wryly.

As the debate over healthcare costs continues in Washington, stories like these highlight the real-world impact of policy decisions on everyday Americans.