Though the ACA expanded coverage to 19 million Americans, some of those gains are reversing. About 28 million remain uninsured. A study by the Kaiser Family Foundation, a health-research nonprofit, determined that most uninsured families simply found health insurance too expensive.


The Bergevins are one of those families.

Lindsie is a freelance graphic designer who focuses on clients in the craft industry. Chris, 34, is a supervisor at the auto shop the Bergevins jointly own with another couple. Though the business is growing, things were tight enough that Chris didn’t draw a salary until last summer. Last year, the couple took home from $40,000 to $50,000, after taxes.

In 2014, when Lindsie was pregnant with Sky, the couple still had coverage through her job at the Idaho Statesman newspaper.

A calculator on her Aetna health plan’s website estimated the Bergevins would need to pay about $3,000 or $4,000 out-of-pocket for Sky’s birth. When the total bill came, the sum for prenatal care, hospital costs, anesthesia, and other care was triple the estimate.

They were still paying off Sky’s birth in 2016 when Lindsie had surgery to remove her tonsils and correct a deviated septum, leaving them with several thousands of dollars more in bills.

She put the sum on a CareCredit medical credit card and is paying $300 each month toward that debt.

As the couple thought more about it, maintaining their coverage made little sense. They were falling deeper into medical debt, despite having insurance which itself cost thousands of dollars a year. In 2016, Lindsie left her newspaper job to devote herself full-time to her thriving freelance design business—and they went uninsured.

“I couldn’t justify it,” she says. The cheapest policy she could find through the Affordable Care Act, she recalls, was $547 a month—more than half the family’s $875 monthly rent at the time. It had a high deductible that could leave them with out-of-pocket costs of more than $10,000.

“If something were to happen to us, we would have been in trouble,” she acknowledges. To hedge, the couple bought an inexpensive accident policy from Aflac that would cover some costs from an injury if, for example, Chris hurt himself working.