Kansas Stories: Jim & Nancy

January 2026

Jim and Nancy live in northeast Kansas and are retired, but far from slowing down.

For the past 15 years they have run a small assisted living business that provides in-home care for seniors. Nancy spent her career in skilled nursing and had long dreamed of owning her own care-focused business. Together she and Jim built a business with work that is deeply personal, and they describe the people they work with as family.

As a small business they employ only a handful of staff. Because of their size they don’t qualify for group health insurance rates. One of their employees receives health coverage through the ACA Marketplace, and Jim and Nancy’s business covers the full cost of that plan. Other employees access health coverage through spouses or other means.

For Jim and Nancy, the Affordable Care Act has made their business model possible. It allows them to care for their employees with dignity and stability — two things that they deeply value.

But that stability is now under threat.

The enhanced premium tax credits on the ACA Marketplace expired at the end of 2025. Without them, the cost of their employee’s health insurance plan has increased by nearly $1,000 per month.

“We need to keep her insurance. We can’t just take that away from her,” Nancy said.

But their small business doesn’t have an extra $1,000 per month to absorb that cost. Nancy worries that their only option may be to pull from their personal retirement savings. This is something that they never imagined having to do to keep an employee insured.

When they first saw the projected increase, Nancy said panic began to set in. They didn’t know where that extra money would come from.

They value and want to keep their employees. But the financial reality of losing the enhanced tax credits threatens the sustainability of their day-to-day operations and the future of their small business.

These fears are shaped by their real-life lived experience.

“Without Obamacare we would have been screwed,” Jim said.

About a decade ago Jim lost his job with a nonprofit based in Washington, DC. At the time, Jim and Nancy were around 63 years old and suddenly without health insurance. Both had chronic health conditions and relied on daily medications. For several months they had no coverage at all until they qualified for a plan through the ACA Marketplace.

They enrolled in that coverage, and just months later Nancy was diagnosed with breast cancer.

“I really believe it saved my life,” Nancy said.

Because they had ACA coverage, Nancy was able to access timely, affordable treatment. Without it the cost of care would have been impossible to cover.

Today Jim and Nancy remember that experience as that same lifeline financially drifts away for their employee.

“People depend on the ACA for insurance,” Jim said.

For Jim and Nancy, this isn’t a political issue — it’s personal. It’s about protecting the people they care for, the business they’ve built, and the health and dignity of Kansas families who rely on affordable health coverage.

“I think Congress needs to understand that these tax credits are incredibly important to people that are trying to get by,” Jim said.