“It’s a second mortgage.” A retired Arizona teacher confronts the increasing cost of health care.

Profile of Eric Kurland in Scottsdale, Arizona

Eric Kurland thought he and his wife had done everything right.

They spent decades in public education. They worked second jobs in the hospitality industry early in their careers. They planned carefully, saved consistently, and retired with what Eric describes as a “modest but responsible” income -- about $80,000 a year from pensions and Social Security.

Then their health insurance bill exploded.

Eric, a retired public school teacher in Scottsdale, Arizona, is 62. His wife is 64. They’re both retired, but neither is old enough for Medicare. That gap -- those few years between leaving the workforce and qualifying for Medicare -- is where their affordability crisis began.

Two years ago, when Eric and his wife enrolled in coverage through the Affordable Care Act marketplace, their premium was manageable.

“Two years ago, it was our first year on the exchange, and it was like $327 for the month,” Eric said.

That price wasn’t random. At the time, enhanced ACA premium tax credits were in place -- temporary subsidies passed by Congress that lowered monthly premiums for millions of Americans, particularly retirees, freelancers, and people without employer-sponsored insurance.

Then those credits expired.

Republicans in Congress voted to not extend them, including his Republican Congressman David Schweikert.

When Eric went back to the marketplace to shop for coverage, the impact was immediate.

“The cheapest plan was $2,218 a month,” he said. “A month. A month?”

The same marketplace. The same family. A radically different cost.

In one year, Eric’s insurance jumped from about $6,200 annually to more than $26,600.

“That’s an $18,000 increase,” he said. “That’s more than 25% of your income… it’s like a second mortgage.”

And unlike a mortgage, there’s nothing tangible at the end -- just the ability to access care.

For Eric’s wife, going uninsured isn’t an option. She carries a genetic mutation that significantly increases her risk of breast cancer and requires regular imaging every six months.

“So needless to say, we’re not gonna do that,” Eric said, referring to the idea of dropping coverage. “That’s not really an option for my wife.”

The couple is now looking to transition to coverage through the Arizona State Retirement System -- if they can -- where premiums will likely be around $1,000 a month. That still doubles what they once paid, but it’s far less than the post-subsidy marketplace price.

“We’re pretty fortunate that’s even there,” Eric said.

Many people aren’t.

Healthcare isn’t the only cost rising, but it’s the one that dominates everything else. In Arizona, extreme heat makes electricity unavoidable. Groceries cost more. Gas costs more. But healthcare is different -- it’s not optional, and it’s not something you can easily delay.

“Besides medical expenses?” Eric joked. “I like steak. It’s expensive.”

Then he paused.

“And my wife can’t really go without insurance.”

That’s the reality behind the policy debate. When the ACA tax credits expired, the cost didn’t disappear -- it was shifted directly onto families like Eric’s, people living on fixed incomes who planned carefully and assumed stability would follow retirement.

“There are people that are literally going to die because they’re going to choose not to have healthcare,” Eric said. “There’s no penalty now if they don’t have it. So what’s their incentive?”

For Eric, the frustration isn’t ideological -- it’s mathematical.

“If you were to buy a house, they tell you not to spend more than a third of your income on your mortgage,” he said. “Now we’re talking about spending that much just on insurance.”

Eric and his wife will keep living frugally. They always have. He has a background in finance. They saved. They planned. They did what they were told would lead to security.

And still, the system shifted beneath them.

“That’s the thing,” Eric said. “We did everything right.”

This is what affordability looks like when policy changes become personal -- when a vote in Congress turns healthcare into a second mortgage for a retired teacher who thought he’d already paid his dues.

Eric’s story is coverage from CAP Action’s Stories program, which interviews and elevates voices across America, across policies and media. For more information about the Stories program or to get in touch with storytellers, email stories@americanprogress.org.