With their Affordable Care Act insurance premium costs set to rise from the current rate of $600 a month to $3,000 starting next year, Elizabeth Aranow and her husband aren’t sure what to do.

“We haven’t purchased a plan yet, because I’m reeling from sticker shock,” Aranow said. The Lander residents could buy a cheaper marketplace plan, but at $1,800 a month, the least-expensive plan available still more than doubles their costs while offering less coverage. The situation has spurred them to consider major life changes, like applying for new jobs with benefits or going without insurance.

But “to me, not having insurance is not an option,” she said. Aranow has experienced injuries that required surgeries in recent years.

Health policy changes, a shifting market and expiring tax credits m

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