Guide explains how a first-time buyer can shop for ACA health insurance

A HealthQ report from KFF Health News and Nashville Public Radio follows DJ Mikunda, 22, a gas station manager in St. Louis, as he looks for health insurance for the first time. He has been uninsured since he left home and started working in 2023. He says earlier visits to the healthcare.gov marketplace left him overwhelmed, and the plans seemed a bit too expensive. He has a chronic joint condition that has gone virtually untreated since he lost Medicaid coverage.

Independent assister Jackie Shrago, who has helped people use the marketplace since the early days of the Affordable Care Act, walked him through the basics. She began with income, because expected earnings for the coming year determine eligibility for lower monthly payments. For 2027 enrollees, a single person with no children can earn up to $63,480 and still qualify. According to KFF's calculator, someone in their mid-20s earning $50,000 would get an average 23% discount. Shrago warned that underestimating income could mean owing money back at tax time.

The story then turns to weighing monthly cost against the level of coverage a person needs. Mikunda may stretch his budget for a plan that covers more of his medical costs.

Readers can search for free independent assisters on healthcare.gov through "Find local help." Unlike brokers, assisters cannot charge for their services or accept pay from insurers. Availability is tightest before the Jan. 15 federal deadline. The story notes that the Trump administration cut funding for assisters and navigator nonprofits by about 90% in 2025. The Centers for Medicare & Medicaid Services said the program was inefficient, costing over $1,000 per enrollee.