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At the heart of the political fight over the government shutdown is enhanced subsidies that have kept the Affordable Care Act insurance a little more affordable. About half of the tens of millions of people on the ACA plans own or work for a small business, and they're now about to do without those subsidies. NPR's Selena Simmons-Duffin spoke with one of them as open enrollment begins.
SELENA SIMMONS-DUFFIN, BYLINE: Angel Strobel lives in Georgia and runs a small business distributing personal protective equipment and safety supplies all over the country. The changes to her ACA insurance for next year have her pretty worked up.
ANGEL STROBEL: I'm irate. I'm pissed off.
SIMMONS-DUFFIN: On average, people's premium costs will double next year. Strobel, who buys insurance for herself and her 20-year-old son, says in her case, the premium is actually not the problem.
STROBEL: My premium does not go up by much. However, the deductible skyrocketed, more than doubled, and the out-of-pocket max almost tripled.
SIMMONS-DUFFIN: That is stressful. But actually, the main thing she's worried about is something called the repayment cap, which is another thing that's changing in 2026. To understand the issue, you need to know that the amount of subsidies you get towards your premium depends on your income.
STROBEL: It's very difficult to estimate what your next year's income is going to be. It's dependent on so many things, especially with Trump's and - tariffs when you're bringing in product from overseas. Like, it's just crazy.
SIMMONS-DUFFIN: It used to be that if you did better than expected in a given year, you had to pay some of any premium subsidies you got back. But the Big Beautiful Bill Republican lawmakers passed over the summer removed the caps.
STROBEL: So let's say that I had a really great year but got sick. I've got to pay back all the premium tax credits and the out-of-pocket max and the premium. You're looking at - I believe I calculated 62% of my income.
SIMMONS-DUFFIN: Angel Strobel says America is supposed to be all about small businesses, which makes her extra angry that she's in such a difficult situation.
STROBEL: It's just mind-blowing. It's mind-blowing.
SIMMONS-DUFFIN: There's still the potential for Congress to make a deal to extend the enhanced premium subsidies, but the repayment caps aren't currently part of the political debate.
Selena Simmons-Duffin, NPR News, Washington. Transcript provided by NPR, Copyright NPR.
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