Joan Belcher of Alna is both a registered nurse and a licensed health insurance broker and Affordable Care Act expert.

For 29 years, I’ve served as both a registered nurse and additionally a licensed health insurance broker and Affordable Care Act (ACA) expert for the past five years here in Maine. I’ve watched individuals, families and small businesses struggle as “affordable” health care becomes a myth. “Affordability” is not a hoax.

I’ve been working 16-hour days for three months helping Mainers react to the loss of ACA subsidies. Hundreds of Mainers and I have had tough conversations about affording monthly premiums, medication costs, cancer care, preventive care and protection against financial disaster.  

To prepare myself for these conversations I knew I had to “talk myself off a ledge” before I could talk anybody else off a ledge. I was contemplating going without insurance rather than spending $15,600 for high-deductible insurance I wouldn’t likely use and even if I did, I would have an additional $10,000 out-of-pocket expense before any real financial protection.

Then I got a call from a client who canceled health insurance in March and had a hospitalization in June.  

She now has a $300,000 hospital bill. That is when I determined that my $1,300 premium isn’t  just health insurance — it’s “house insurance,” protecting me from a lien against my home if I ended up with a $300,000 bill through no fault of my own.

I’m not alone. A retired couple I work with faces $3,800 health insurance premiums (29.5% of their income) in January after losing their ACA subsidies, forcing them to downgrade their Silver level plan to a Bronze plan for 2026. With a Silver level plan they have a $60 copay to see a specialist but the lowest-cost Bronze plan leaves them subject to an unknown contracted rate the provider has agreed to. So much for cost “transparency.” 

A small business with nine employees saw a $15,000 increase for 2026. Even my Medicare clients are seeing higher copays, reductions or elimination of routine dental care and higher max out-of- pocket costs. Meanwhile, members of Congress have 72% of their premiums covered by taxpayers and most of them choose Gold level plans on the taxpayers’ dime. They’re out of touch with what Mainers face.

This isn’t just a personal burden; it’s an economic crisis for our state and our country. When people avoid care, they get sicker and end up in the hospital, incurring even greater costs. We need to define what “affordable” health care really means.

As a health care professional, I know what happens when people avoid care because they have a high-deductible plan and don’t know what it’s going to cost them. They put off care, and then I see them at Maine Medical Center in a bed, out of work, unable to care for their family and they are definitely meeting their deductible. 

Why? Because we are stubborn, independent, strong Mainers and have family to support and jobs to do. We are not shirkers, we pay our way. We also pay 72% of Congress’ health insurance Gold level plans.

It is “time to fish or cut bait,” as we say in Maine.

Maine has a help-wanted sign in the window, and we’re interviewing for job applicants next November. We need to hire representatives willing to sit down with those they disagree with and craft real solutions to the very real health care crisis. It’s time to create a universal health care system that works for everyone, not just career politicians.