24 million Americans watched premiums double overnight. Now Trump plans to pressure insurers who banked $543 billion in profits over a decade. The solution? HSAs—which create new revenue streams for the same industry while shifting costs onto patients who already can't afford care. This isn't reform.

Congress left while ACA subsidies expired. Premiums spiked 114%. UnitedHealthcare dumped costly seniors. RFK Jr. gutted the CDC. NIH cancer research was slashed. The advocacy community stayed silent. 2025 was a catastrophe for patients. If you can't admit that, you're complicit. Be pissed.

Congress left for vacation knowing ACA subsidies would expire. In 2026 premiums spiked as high as 114 percent, millions face dropping coverage, and patients carry the cost. This is not partisan politics. This is survival, access, and who gets left behind.

People call it overnight success. From the inside it looks like decades of repetition endurance and saying uncomfortable truths out loud. This reflection examines advocacy patience family grounding and why progress in healthcare only comes through time memory and staying power.

Congress let ACA subsidies expire and premiums are set to more than double. Most ACA enrollees live in GOP districts now facing coverage loss hospital closures and higher costs for everyone. The healthcare death spiral has arrived and it targets its own voters first.

Prior authorization delays cancer care and drives preventable deaths. Oncologists report treatment denials disease progression and ER visits caused by insurer delays. What began as medical review now functions as weaponized paperwork that outlasts patients.