Blake Farmer, Nashville Public Radio
It’s feeding time for the animals on this property exterior Nashville, Tennessee. An albino raccoon named Cricket reaches by means of the wires of its cage to seize an animal cracker, an appetizer deal with proper earlier than the night meal.
“Cricket is blind,” stated Robert Sory, who’s making an attempt to open a nonprofit animal sanctuary alongside along with his spouse, Emily. “A lot of our animals come to us with issues.”
The menagerie in Thompson’s Station contains Russian foxes, African porcupines, emus, bobcats, and a few well-fed goats.
The Sorys are enthusiastic about their pets and appear to place the animals’ wants earlier than their very own.
Both Robert and Emily began 2026 with out medical insurance.
Robert had been coated by means of a market plan sponsored by means of the Affordable Care Act. His share of the month-to-month premiums was $0. When he regarded up the charges for 2026, he noticed {that a} barebones “bronze”-level plan would value him a minimum of $70 a month. He determined to forgo protection altogether.
“When you don’t have any income coming in, it doesn’t matter how cheap it is,” he stated. “It’s not affordable.”
Dumping Coverage
Marketplace plans from the Affordable Care Act not really feel very inexpensive to many individuals, as a result of Congress didn’t lengthen a package deal of enhanced subsidies that expired on the finish of 2025. Last week, the House did move laws to increase the expired subsidies, and negotiations have moved to the Senate. Without a deal, an estimated 4.8 million will go with out protection this 12 months.
But even with out a well being plan, individuals will nonetheless want medical care. Many, just like the Sorys, have been pondering by means of their plan B to keep up their well being.
The Sorys each misplaced jobs in November, inside days of one another. Robert labored as a farmhand. Emily labored at a staffing agency and misplaced her insurance coverage alongside together with her place.
“It’s a horrible, horrible market right now. Really tough,” she stated.
The first time she needed to pay out-of-pocket for her three month-to-month prescriptions, the price was $184.
“To equate that to kind of how we think about it, you’re talking about 350 pounds of food for these animals,” Robert stated. He pointed to his bobcats, who eat solely meat.
Workarounds for the Newly Uninsured
To maintain kibble within the meals bowls, the Sorys are prepping for an uninsured future. They see the identical psychiatrist and met with him to make a plan. He was prepared to work with them by charging $125 per go to. They’ll must go each three months to maintain their prescriptions present.
And if different medical issues emerge? They’re hoping for one of the best.
“I’m not somebody who gets sick super often, thank God,” Robert stated. “And if I do, generally I go to an emergency room where they’re going to bill me later.” Robert stated he would organize a reimbursement plan for payments like that.
Emily has expensive well being situations and has already taken on substantial medical debt. “It’s just sitting there, and I’ve racked up money,” she stated. “But I’ve had to go to the doctor.”
Donated Drugs and Sliding Scales
Hospitals and clinics are bracing for the influx of newly uninsured sufferers. They’re additionally involved that folks gained’t learn about other ways to get medical care.
“We don’t have marketing dollars, so you’re not going to see big billboards or radio ads,” stated Katina Beard, CEO of Matthew Walker Comprehensive Health Center in Nashville. It’s one of many nation’s 1,400 federally certified well being facilities, additionally referred to as FQHCs.
FQHCs are partially funded by the federal authorities. Although they don’t often provide free care, their charges are typically decrease or on a sliding scale.
Uninsured individuals who get care obtain a invoice, Beard stated, “but the bill will be based on their ability to pay.”
FQHCs typically have on-site pharmacies, and a few provide prescription drugs freed from cost by means of a partnership with the Dispensary of Hope, a Nashville-based nonprofit.
Many hospital pharmacies additionally accomplice with the nonprofit, which has distributed medication donated by pharmaceutical firms to 277 websites in 38 states. Participating pharmacies should make the drugs out there freed from cost to individuals with out insurance coverage who’ve annual incomes under 300% of the federal poverty restrict.
The group primarily sources drugs for persistent situations corresponding to hypertension, diabetes, and psychological well being. Demand is predicted to outstrip provide within the new 12 months, in keeping with CEO Scott Cornwell.
“We’re projecting and engaging with our manufacturers and asking them, ‘Are you willing to help support, for this future status that we are anticipating?’” he stated. “By and large,” he stated, pharmaceutical firms have stated they’re prepared to step up.
“It’s a continuous conversation that we’re having,” Cornwell stated.
A Medicaid ‘Gap’ in 10 States
Hospitals may also must discover a solution to take care of extra sufferers who can’t pay. Industry teams such because the Federation of American Hospitals have been vocal concerning the menace to hospitals’ monetary well being and have urged Congress to increase the improved subsidies, which take the type of tax credit.
The affect is perhaps most acute in states like Tennessee that haven’t expanded Medicaid to cowl individuals who work however should not have job-based insurance coverage and can’t afford it on their very own.
Ten states have chosen to not develop Medicaid to uninsured, low-income adults — an elective provision of the ACA that’s primarily paid for by federal funds.
This Medicaid “gap” is expected to cause uninsured rates to jump, on the excessive finish of the spectrum, by as a lot as 65% in Mississippi and by 50% in South Carolina, in keeping with the Urban Institute.
As Emily Sory pets a Russian fox, she admits she is keenly conscious that she’s going to quickly change into a part of this rising inhabitants. After all, her final job concerned well being care staffing. Her mom is a nurse.
“I understand the system. And I get it’s people like me that don’t pay their bill are why it suffers. And I feel bad,” she stated. “But at the same time, I don’t have the money to pay it.”
This article is from a partnership that features Nashville Public Radio, NPR, and KFF Health News.
