Molly Hetrick lives in Centre County where she works as a consultant, helping small nonprofits with fundraising. When she left a full-time job to build her own business more than a year ago, that meant finding health insurance.
“I did go on to Pennie for the very first time, and I selected insurance and felt like I got a really good plan," Hetrick said.
Pennie is Pennsylvania’s health insurance marketplace. People like Hetrick — whose jobs don’t come with insurance — along with small businesses, can use Pennie to find coverage.
But this year, thousands of Pennsylvanians are dropping the health coverage they get through Pennie and others are seeing their rates skyrocket as the enhanced tax subsidies that helped millions of Americans pay for their health insurance expired at the end of 2025.
For Hetrick, when she crunched the numbers of what she’ll have to pay to keep her coverage this year, the cost jumped.
“I just started building my business. I had a fantastic first year. I'm not ready to stop, but I need health care," she said. "Someone jokingly said, how about you get married? Find a husband who has a good health care plan.”
In the end, Hetrick opted to keep her coverage and pay $580 a month — up from about $440 dollars a month last year.
And she’s not alone. For many the increase will be steeper — this year, the average monthly cost for Pennie enrollees will more than double.
That’s because, even after a drawn-out battle, the Republican-led Congress did not renew the enhanced tax credits that help people afford health insurance through the Affordable Care Act. At the same time the prices insurers are charging are climbing.
Lisa Davis is the director of the Pennsylvania Office of Rural Health and a faculty member in health policy at Penn State. Looking at the rising health care costs in Pennsylvania, Davis pointed to rural counties seeing major price spikes.
“The cost of it's going to be so expensive," she said. She said people under 19 can be on CHIP and those 65 and older can get Medicare, "but it's that 19 to 64 group that will be really challenged.”
That’s showing up in the numbers. So far, almost 70,000 Pennsylvanians have dropped their coverage through Pennie. It follows a year a record-setting half million Pennsylvanians got coverage through Pennie. Now, an average of 1,000 Pennsylvanians are dropping coverage each day, according to the state's health insurance marketplace.
That’s as rates go up an average of $145 a month in Centre and Blair county, $229 a month in Cameron County and $367 a month in Juniata County.
“I honestly don't know what’s going to happen over there," Davis said. "My thought when I say this — and this is just my estimate — is that 80% of residents in Juniata County, adults, will be uninsured between the ages of 19 to 64.”
Paula Williams is the executive director of Centre Volunteers in Medicine, which provides free medical and dental care to about 1,100 people a year who don’t have insurance. She says the organization is looking for ways to be ready for the need to increase.
“Our goal is: how do we take care of them," Williams said. "And I understand that these decisions are being made about rates and those kind of things, and we cannot control that, but we can control the care that we are providing.”
Experts say, if more people are uninsured that will put more stress on other parts of the health care system, like hospitals and free clinics.
“When one person doesn't have access to health care when they need it, there is a ripple effect in the community," said Kristen Houser Rapp, the executive director of the Pennsylvania Charitable Health Care Coalition. The coalition represents 27 free clinics that serve people who don’t qualify for Medicaid and cannot afford insurance through Pennie.
“It's scary," she said. "Your mission is to be there to help people, and to feel like you can see a tidal wave in the distance coming your way and you don't know exactly when it's going to hit or how bad it's going to be."
And, she said, if people don’t have health insurance, but need care for an illness or accident or emergency, hospitals will end up with more unpaid bills. And that will get passed on to insurers, employers and people with insurance.
“So taking away the tax credits and the affordability of health coverage for low-income Americans, low-income Pennsylvanians, is really spreading that burden back onto everybody else in the community, the employer, small business employers who've already been complaining about the cost of being able to provide health care benefits for their employees, that's going to go up," Rapp said.
Rapp and Davis both say even more people are expected to lose health coverage going into next year when Medicaid changes signed into law take effect. Those include new work and paperwork requirements.
Davis said what’s happening now could be a “training period for Pennsylvania and for the country before we see the tsunami of uninsured that will start in 2027 when we begin to look at all of the changes in Medicaid coverage.”
Pennsylvanians have until the end of January to enroll in Pennie under an extended deadline.
