BETHLEHEM, Pa. — Premiums for Affordable Care Act policies have spiked across Pennsylvania after federal subsidies expired this year, but residents in the Greater Lehigh Valley are getting the brunt of it.
On average, ACA policy premiums for Lehigh County residents jumped $330 a month — a 205% spike over last year's average, according to Pennie, Pennsylvania's health insurance marketplace.
Meanwhile, Northampton County residents saw their policy premiums cost an extra $317 a month, a jump of 163%, according to Pennie.
The most recent round of data, based on 2023 statistics, found that 41% of families in Carbon, Lehigh and Northampton counties struggled to cover basic amenities.United Way's Asset Limited, Income Constrained, Employed data
The region is among the hardest hit in Pennsylvania in terms of premium hikes. Only residents of Juniata and Fulton counties saw their rates climb higher, at an average of $367 and $336 a month.
Carbon County customers weren't much better off, with an average increase of $303 a month.
The rising premiums are part of the larger affordability crisis with which working families are wrestling here and across the country.
In an effort to gage the financial health of a community, the United Way has developed a metric called ALICE.
The tool, which stands for Asset Limited, Income Constrained, Employed, determines the cost of modest living expenses in an area, then reviews how many of regional households can afford those standards.
The most recent round of ALICE data, based on 2023 statistics, found that 41% of families in Carbon, Lehigh and Northampton counties struggled to cover basic amenities.
'Had to make a really hard choice'
Erin Connelly, vice president of community solutions for the United Way of the Greater Lehigh Valley, said health care prices, alongside the costs of housing and childcare, are some of the biggest financial challenges with which local families wrestle.
The ALICE calculation determined a household of two adults, an infant and a toddler living in the region would have needed to pay about $660 a month in health care costs as part of a barebones budget, Connelly said.
However, that should be considered a best-case scenario, she said. A single accident or serious illness could result in far higher prices that could sink a family's finances.
"Health care costs are so unpredictable. You can make your best guess and really hope that nothing serious happens, but there's no way to know for sure. That's a cost that creates those really impossible choices that need to be made."Erin Connelly, vice president of community solutions for the United Way of the Greater Lehigh Valley
"Health care costs are so unpredictable," Connelly said. "You can make your best guess and really hope that nothing serious happens, but there's no way to know for sure.
"That's a cost that creates those really impossible choices that need to be made."
Often, families try to make ends meet by skimping on their food budget, she said. Food pantries across the region have reported growing demand for their services in recent years.
But the Pennie data suggests families are increasingly gambling on their health care coverage.
From 2025 to 2026, Pennie enrollment dropped by 10,084 people statewide. The 2% decrease marked the first time participation has fallen in the program's history, according to Kelsey Cameron, a marketing and communications manager at Pennie.
Even in cases where people remained enrolled in Pennie, there was a growing trend of customers shifting to policies that presented more risks.
Pennie sold 32,534 more Bronze level policies in 2026 than it did in 2025; the Bronze plans charge lower monthly premiums but leave customers with higher bills if and when they actually use the service.
The number of Silver level policies, which charge higher premiums in return for lower co-insurances, fell by 38,809 policies year-over-year, according to Pennie data.
"To me, that signifies that is a family or an individual that had to make a really hard choice," Connelly said.
No deal in Washington
While it's not unusual to see health insurance costs climb year after year, the ACA spike can be tied directly to the end of enhanced tax credits.
The larger subsidy was passed as part of the Inflation Reduction Act in 2021, but expired in January.
The tax credits were at the heart of the longest-ever federal shutdown late last year.
While Democrats demanded the credits continue unabated, the Republican caucus was divided between moderates who wanted to reform the system and conservatives who wanted to turn the page.
"The problems in our health care system were caused by excessive partisanship, and it will take members willing to work together to deliver the accountability, relief, and transparency that our communities deserve."U.S. Rep. Ryan Mackenzie, R-Lehigh Valley
U.S. Rep. Ryan Mackenzie, R-Lehigh Valley, lobbied for a reform deal but grudgingly crossed party lines when House Speaker Mike Johnson, R-La., opted not to make extending the credits a priority once the government reopened.
While Mackenzie's vote let the ACA tax credits to pass the House, a similar deal never materialized in the Senate.
In a statement this week, Mackenzie renewed his attacks on Democratic leaders, saying they refused to engage in good-faith negotiations to preserve the taxes.
Everyday Americans are paying the price for partisanship, he said.
"The problems in our health care system were caused by excessive partisanship, and it will take members willing to work together to deliver the accountability, relief, and transparency that our communities deserve," Mackenzie said.
In his district, there's a chance those costs won't be strictly financial.
As of last week, 8,383 Pennie customers in Pennsylvania's 7th Congressional District — 29% of all Pennie customers in the region — had dropped their Pennie plan since the start of the year.
