As the open enrollment period for the Affordable Care Act (ACA) marketplace begins, millions of Americans are bracing for a significant surge in health insurance costs. Approximately 24 million individuals currently purchase health insurance through the marketplace, with the majority benefiting from tax credits that reduce their monthly premiums. However, these subsidies are set to expire at the end of the year, potentially leading to an average increase of 114% in monthly costs, according to the health research nonprofit KFF. This could translate to an additional $1,000 annually, or even more in some cases. For small business owners like Stacy Cox and her husband in Utah, the loss of tax credits could mean their monthly premiums skyrocket from $495 to $2,168—a staggering 338% increase. Ms. Cox, who has an autoimmune disease, and her husband, who suffers from hereditary cardiovascular disease, are considering canceling their health plan and opting for emergency insurance, which would not cover routine or preventative care. Experts warn that if the subsidies are not extended, around seven million people may stop buying insurance through the marketplace, with four to five million likely to lose coverage entirely. The issue has become a focal point in the ongoing federal government shutdown, now in its second month. Democrats are pushing to renew the subsidies and reverse steep Medicaid cuts made by former President Donald Trump. While some Republican lawmakers oppose the subsidies as part of the ACA, others, including Trump ally Marjorie Taylor Greene, have expressed support for their continuation. Meanwhile, the government shutdown has also threatened food aid programs like SNAP, which serves over 40 million Americans. A recent court ruling has temporarily ensured the continuation of SNAP benefits, but the broader healthcare and financial uncertainties remain unresolved.