Pennsylvania bike shop owner John Ronca has been buying health insurance through the Affordable Care Act marketplace for over a decade. Last year, with enhanced ACA tax credits enacted under the Biden administration, the premiums for his gold plan—the second-highest tier, which includes lower deductibles and often more flexibility in seeing specialists—tripled. Ronca decided to go for a bronze plan with a higher deductible to make sure he, his wife, and his young daughter were still insured.