In this end-of-year episode, Tom Quigley delivers a blunt post-mortem on what many Americans feared — and hoped wouldn’t happen.
The enhanced ACA subsidies have officially sunset, and the fallout is immediate and brutal. Premiums that were once manageable have exploded overnight, forcing families, couples, and small business owners into impossible choices:
pay unaffordable premiums, go uninsured, or gamble with their financial future.
Tom doesn’t just react — he explains why this happened, who benefits from the chaos, and why the system is failing exactly as designed. This episode connects the dots between uneducated consumers, corrupt incentives, and a healthcare structure that punishes logic while rewarding greed.
🔍 Key Topics & Insights
1. The Enhanced Subsidies Are Gone — and the Damage Is Real
Tom confirms what many listeners are now experiencing firsthand:
Enhanced subsidies are fully sunset
Premiums jumped immediately
Some people chose to drop insurance entirely — even catastrophic coverage
Tom:
“They’re saying, ‘Why would I waste money on it?’ And that’s terrifying.”
2. Real Numbers: From $200 to $2,800 a Month
Tom shares a shocking real-world example:
Couple paying ~$200/month
New premium: $2,800/month
That’s not inflation — that’s a de facto tax increase of over $24,000 per year.
Neil:
“That’s a 3,000–4,000% increase.”
Tom:
“Unreal — and totally avoidable.”
3. Why People Are Going Uninsured
With costs this high, some individuals are:
Skipping insurance altogether
Rolling the dice for a year
Waiting for Medicare eligibility
Using only virtual care and DPC
Tom is clear:
“That’s not smart — but it’s understandable.”
Without catastrophic coverage, one event can mean:
Bankruptcy
Lifetime payment plans
Financial ruin
4. Medicare vs. the Rest of the System
Tom draws a sharp contrast:
Traditional Medicare remains the best insurance in the world
Yes, Part B and supplements increase — but nothing like ACA plans
Medicare Advantage may fluctuate, but Medicare itself is stable
For everyone else?
“They’re paying more for health insurance than a mortgage.”
5. Direct Primary Care: The One Thing That Still Makes Sense
Tom reinforces what he’s said all year:
Direct Primary Care (DPC) is a no-brainer
Flat monthly fee
Unlimited visits
Massively discounted labs and diagnostics
Longer doctor visits
Real preventive care
Tom’s own example:
“I had $2,000 worth of labs done for $100.”
One or two lab visits alone often cover the entire annual DPC cost.
6. Will Enhanced Subsidies Ever Come Back?
Tom is pessimistic — but practical.
He outlines the only two logical paths forward:
Option 1: Government Fully Involved
$50,000 deductible for every American
Government buys reinsurance
Savings fund the system
Catastrophic protection guaranteed
Option 2: Private Market + High-Risk Pool
Allow medical underwriting again
Government funds high-risk individuals
Insurance companies cover healthy pools
Costs drop dramatically
Either option:
Saves trillions
Restores logic
Requires political courage
7. Who’s Really Blocking Reform
Tom pulls no punches:
Corrupt Departments of Insurance collecting premium tax
Commission-based agents protecting income
Hospitals inflating costs unchecked
Pharma posturing while avoiding real reform
Lobbyists controlling policy
Tom:
“It’s a big dupe — and the American public doesn’t know enough to fight back.”
8. The Education Crisis Nobody Wants to Talk About
Tom identifies the core issue:
Americans understand mortgages and car loans
They do not understand health insurance
No education in:
Grade school
High school
College
Result:
“People pay more for healthcare than housing — and don’t question it.”
9. The ACA Isn’t the Villain — Ignorance Is
Tom makes a critical distinction:
What the ACA did right:
No preexisting exclusions
No lifetime limits
Preventive care
What went wrong:
No flexibility
