JOHNSON CITY, Tenn. (WJHL) — Karen Cross isn’t sure where she and her husband Greg will cut their budget next year, but the retired public school teacher is preparing as the couple awaits a potential large increase in their Affordable Care Act (ACA) health insurance premiums.

“We’ve already gotten an email from our insurance company, and we also got an email and a text, both from the government, saying that we could expect very high premiums next year,” Cross told News Channel 11 Wednesday.

“We’ve been told we can expect (monthly) insurance premiums to go up way past $1,000. $12,000 a year when you are on an income of $50,000 is a lot.”

The Crosses’ situation — shared by millions of other Americans who buy ACA marketplace insurance — stems from a pending expiration of expanded premium tax credits that help offset many customers’ out of pocket premium payments. While some credits would remain in place, the so-called ‘One Big Beautiful Bill’ passed last spring triggers the end of additional credits that were implemented in 2021 — the same year Karen Cross had breast cancer surgery.

Senate Democrats have made the issue a rallying point of the current government shutdown, and polls have showed a majority of Americans oppose the scheduled level of cuts to the subsidies.

“It’s going to cause huge chaos, people losing insurance and others seeing their premiums spike, so we said ‘let’s fix this’ and we said it knowing many Republicans have been out since the June passage of the reconciliation bill saying let’s fix it,” Sen. Tim Kaine said during a Zoom news conference.

News Channel 11 asked Tennessee’s two Republican senators, and Tennessee First District Congresswoman Diana Harshbarger (R-Kingsport) and Virginia Ninth District Congressman Morgan Griffith (R-Salem) for statements on the issue. All said a government shutdown was not the appropriate forum to negotiate the issue, though Griffith and Harshbarger both expressed an openness to negotiation (their full statements are at the end of this article).

‘We can’t be without health insurance’

“I am not able to get any private insurance for seven years, so I depend on the ACA,” Cross said. After her May 2024 retirement and the couple’s transition to a Blue Cross Blue Shield ACA plan, Greg Cross later developed a condition of his own that also makes him ineligible for private market insurance. Both are too young for Medicare just yet.

Multiple studies since that bill passed have reckoned the change could roughly double the average out of pocket for an American on ACA insurance. That’s in line with what the Crosses have been told, though details remain imprecise until insurance companies announce their own premium changes and reenrollment for 2026 begins Nov. 1.

A recently released analysis from Virginia’s State Corporation Commission provides estimates for three scenarios and three income brackets across several state metro areas: a single 45-year-old, a 60-year-old couple and a 40-year-old couple with two younger children.

A 60-year-old couple with an income of $63,450, which is higher than the Crosses, would pay around $250 monthly in each metro area under the current enhanced subsidies. That would increase by $210 without the subsidies, representing an 82% increase.

Cross, who engaged in an exchange on the issue with Harshbarger at a Feb. 28 town hall, said the increase would change their lives, but that they can’t do without coverage. She said Harshbarger committed to protect insurance for people like Cross whose pre-existing conditions prevented them from getting on the private market.

The exchange, which was posted to YouTube, does reveal Harshbarger saying a safety net would remain for patients like Cross.

“It’s up to me and my physician colleagues and my health care colleagues on both sides of the aisle to make sure there is some kind of program for those uninsurable patients,” she said. The Congresswoman did not directly address ACA premium tax credits in the exchange, nor did Cross directly ask about them.

Cross said the couple has been satisfied with their coverage.

“We could really only afford to get the cheapest plan, but it’s still very good,” she said.

“We will go ahead and enroll and we’ll have to figure out what we’re going to do,” Cross said. “It’s been a lifesaver for us. We’ve had to rely on our insurance quite a bit in the last two months, and I’m very happy with it.”

Whatever the outcome after the standoff over premium tax credits, Cross said she and her husband believe they have just one option.

“We will go ahead and reenroll, because we can’t afford to be without health insurance. From there, we’ll have to figure out whether we’re both going to try to reenter the workforce.

“It will probably be me that has to enter the workforce with my husband’s preexisting condition now, but, you know, we’ve worked our whole lives, and I thought that this was something that we could depend on.”

‘I do think there’s space for a deal very soon’

Kaine told News Channel 11 he empathizes with the anxiety gripping families like the Crosses.

“Anyone is worried about losing health care coverage but if you’re a cancer survivor … the prospect of losing your health insurance or seeing your premiums go sky high is very very troubling,” Kaine said.

But he added that he believes Senate Democrats may have picked a strong issue around which to rally. More than 24 million Americans are in marketplace plans this year.

Kaine said he thinks health care inflation and access limitations have five “cascading negative consequences.” Those include people losing insurance, premiums rising for those who have it, providers closing and people losing jobs.

He said he believes citizens realize these things, and that ACA insurance’s impact is so broad that constituents are making noise in Republican districts — raising his hopes of a compromise.

“Within the month of October we should be able to find a deal on this,” he said. “And what makes me feel like it’s out there within our reach is the number of Republicans who are out there who have said ‘we’ve got to fix this.’

“Mike Johnson (Speaker of the House) has said we gotta fix it, (Texas) Senator John Cornyn, (Missouri) Senator Josh Hawley, (Alaska) Senator Lisa Murkowski. Yesterday Congresswoman Marjorie Taylor Greene, who I’m normally not on the same side with on much, she said we gotta fix this.”

Kaine said President Donald Trump also expressed a desire to “do something on the premium subsidies” within the past several days.

The 2021 enhanced premiums provided subsidies for some Americans at relatively high income levels, well above that of the Crosses. Kaine said he is hopeful Democrats would welcome some give and take on the issue.

“If the GOP says there’s this or that element that we think needs to be made tighter, or the eligibility shouldn’t be for people at the top end of the income scale — if there’s program improvements, I’m all ears,” Kaine said. “I’m on the health committee in the Senate. But no Republican has handed me, here’s what we need to fix.”

Kaine said if President Trump engages and expresses openness to negotiation, that could open the door to get “core leaders around the table.”

“If Republicans have ideas about improvements — we know that what we are asking for, you don’t ask for something with the expectation that they’re just going to say, ‘100 percent I agree.’ It’s a negotiation. We want to see people protected from rising health care costs and we’ve heard you say the same thing, so let’s negotiate about how to do it.”

Like Kaine, Cross said she believes that in addition to people, the economy will suffer without some compromise. She also thinks a lot of people will simply go without insurance.

“Some Tennesseans, the only choice they’ll have is to show up at the emergency room,” Cross said.

“Everyone’s health insurance premiums are realistically probably going to go up as a result of this. This is not good economically. It’s not just a moral issue for those of us who can’t get health insurance.”

Cross is holding out hope for a negotiated deal that will lessen the pain she and her husband could face next year.

“I appreciate the Democrats that are fighting for us. And I still have hope that there are going to be some Republicans that will realize, you know, that they’ve got to break with Donald Trump on this, that they’ve got to look at what’s best for their constituents.”

The statements from Diana Harshbarger, Morgan Griffith and Marsha Blackburn are below:

“My priority right now is reopening the federal government so we can restore WIC funding, pay our troops, and keep critical programs moving. I am willing to discuss health care policy, but not while Democrats are holding the federal government and the American people hostage. The first step is simple: support the bipartisan, clean CR to reopen the government. Once the lights are back on, we can return to negotiations without Democrats using Americans as bargaining chips.”

Tennessee Congresswoman Diana Harshbarger

“I had previously indicated an interest to establish a glide path on the temporary program that Democrats created during the COVID-19 pandemic to help families who had no or reduced income.

“However, how can we have good-faith, bipartisan negotiations on the temporary ACA ‘enhanced’ premium tax credit issue when Democrats continue voting to shut down the government??!!

“The current controversy was supposed to be about funding the government for a mere 7.5 weeks. But Democrats demanded they receive everything on their $1.5 trillion spending wish list.”

Virginia Congressman Morgan Griffith

“Republicans delivered for the American people in the One Big Beautiful Bill by eliminating waste, fraud, and abuse from the Affordable Care Act marketplace and creating a $50 billion rural health fund. Now, Chuck Schumer and Senate Democrats are holding government funding hostage because they want to undo all of these wins while spending an additional $1.5 trillion to appease their far-left base.”

Tennessee Senator Marsha Blackburn