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In battleground House seat, health care costs stir fears of 2026 reckoning
In a swing district in a swing state, the expiration of Affordable Care Act subsidies is resonating in voters’ lives — and Republicans may pay the price in the midterm elections.
Diane Holland looks in her Blue Cross Blue Shield app and sees her new, higher premium.MS NOW
OKEMOS, Mich.— Diane Holland opened her Blue Cross Blue Shield app and felt her stomach drop. On Jan. 1, her monthly health insurance premium will more than double, jumping from $124 to $252.
The 60-year-old Okemos resident, who lives with multiple sclerosis and is a breast cancer survivor, depends on coverage through the Affordable Care Act marketplace. With enhanced subsidies set to expire, the $1,536 annual increase will force impossible choices.
“It’s a lifeline,” Holland said of her insurance. “It saves me from deterioration with MS. Without it, I can’t get the drug treatments, which are expensive. This November, I had my five-year clear [from] breast cancer. So if I didn’t have it, I couldn’t afford treatments.”
Her predicament reflects a looming crisis in Michigan’s seventh congressional district, a political bellwether and one of the closest House races in the country. It flipped from blue to red in 2024, when Republican state Sen. Tom Barrett won the seat being vacated by Democrat Elissa Slotkin, who left to run for U.S. Senate. As Republicans work to hold their narrow House majority, the health care debate has become a test of whether they can govern on cost-of-living issues that helped elect them — or whether those same concerns will be their undoing.
More than 23,000 people in MI-07 are projected to lose health care coverage entirely in 2026 due to the One Big Beautiful Bill’s Medicaid cuts and expiring ACA premium tax credits, according to the congressional Joint Economic Committee. Statewide, 484,000 of the roughly 531,000 Michiganders who receive insurance through the ACA marketplace depend on the enhanced subsidies set to expire at the end of 2025.
The crisis has created additional turmoil in Michigan’s insurance marketplace. Three providers — HAP CareSource, Molina Healthcare and Physicians Health Plan — are dropping out of the state’s ACA marketplace entirely, leaving only seven insurers and forcing an estimated 200,000 Michiganders to find new coverage options.
The anxiety crosses party lines — and doesn’t just affect those on ACA plans.
Daniel, an 82-year-old DeWitt resident who declined to share his last name due to concern over backlash for discussing politics, just learned his insurance plan was no longer being offered.
“I had to go out and find new insurance at 82 years old, and obviously the benefits aren’t as good as my old one,” he told MS NOW. “I’m going to pay more.”
I had to go out and find new insurance at 82 years old, and obviously the benefits aren’t as good as my old one.”
Daniel, an 82-7ear-old Trump supporter
He’s a veteran, a Republican and a supporter of President Donald Trump. But he isn’t thrilled with Trump’s handling of health care.
“I’m waiting for him to get more involved,” he told MS NOW. “I’m waiting for him to tell both parties, ‘Enough is enough. Stop this, get in a constructive dialogue, come up with proposals and debate those proposals, what’s good for this country.’”
Rep. Tom Barrett, the Republican who represents the seventh district in Congress, declined to share which health care bill he would vote for or if he would support extending ACA enhanced subsidies, but noted he is considering several paths forward.
“I’m open to any serious solution that puts patients first and makes meaningful reforms,” Barrett told MS NOW in a statement. “In addition to reviewing the proposals being circulated, I’m exploring how we can correct the Obamacare medical loss ratios that benefit insurers, take significant steps to mitigate fraud in our health care systems, and expand access to accounts like FSAs or HSAs.”
As Congress is poised to fail to prevent ACA subsidies from skyrocketing in 2026, Barrett’s potential challengers are seizing on the issue.
Matt Maasdam, one of several candidates vying for the Democratic nomination, said Barrett will have to answer for his votes. “He can’t come here and take money from your average citizen to line the pocketbook of billionaires and get away with it,” Maasdam said. “He is responsible to the voters of this district, and they’ll vote them out.”
Another Democratic candidate, Bridget Brink, who was diagnosed with breast cancer over the summer, cast it in personal terms: “As I was diagnosed with breast cancer over the summer, I watched Tom Barrett and DC Republicans take health care from 25,000 people in Michigan, stop life saving cancer research, including here at MSU, and basically make health care more expensive for everyone,” she told MS NOW.
Both candidates emphasized the need to reduce costs, an acknowledgment of affordability’s paramount importance in the current political landscape.
Sen. Elissa Slotkin, who previously represented the district and was first elected to the House in 2018 amid attempts to repeal the ACA, told MS NOW that America’s health care system needs comprehensive reform but argued that allowing subsidies to expire would be catastrophic.
“We’re doing band aids on top of band aids; I’m not the first person to say that,” Slotkin said. “If someone’s got a cut and it’s open, we want to do a whole procedure and the sutures and the whole thing. But if I can’t get that, I will take the band aid to stop the bleeding. And that’s how I feel about Obamacare.”
Slotkin predicted Republicans will face swift political consequences in 2026. “One Big Beautiful Bill is signed in July, premiums go up in November and December, people start paying more in January — that’s just facts,” she said. “That’s not politics, that’s just straight up what happens when you legislate here in Washington — and my colleagues are going to have to answer to those people who are just devastated because they can’t afford their insurance.”
For Holland, weeks away from her premiums doubling, the debate in Washington feels disconnected from the reality she faces.
“It just means I personally have less money to live by, because my income doesn’t go up,” Holland said.
And as the January deadline approaches, she’s clear about who she’ll hold accountable if her costs skyrocket, as planned.
Asked about the 2026 midterms and Rep. Barrett’s political future, she didn’t hesitate. “I don’t foresee him being in a second term,” she said. “It’s just not health care — it’s the cost of living, and we’re all being affected one way or another.”
