Why Health Insurance 101 Matters More Than Ever
After more than a decade working in the health insurance industry, I've seen the same pattern play out countless times: smart, capable people struggling to understand their coverage options not because they lack intelligence, but because the system itself is designed to be impenetrable.
That's why I'm passionate about health insurance education. And honestly? It's never been more critical than it is right now.
The Jargon Problem
Let me be blunt: our industry has a language problem. We've created a vocabulary that feels purposefully exclusionary—deductibles, coinsurance, out-of-pocket maximums, formularies, prior authorizations. These aren't just technical terms; they're barriers that stand between people and the healthcare they need.
I've watched people nod along in enrollment meetings, too embarrassed to admit they don't understand the difference between a copay and coinsurance. I've seen families choose the wrong plan because they couldn't decode what "bronze" versus "silver" actually meant for their wallet. I've fielded panicked calls from people who thought they had good coverage, only to discover they didn't understand their deductible.
The worst part? None of this is the consumer's fault. The system isn't structured for easy navigation. It's structured for... well, I'm not always sure what it's structured for, but it certainly isn't clarity.
The Stakes Are Higher Than Ever
Here's what keeps me up at night in 2025: healthcare costs are rising at an alarming rate, and the support systems that made coverage affordable are eroding.
In Vermont, where I focus my work, we're facing a potential crisis. The enhanced federal subsidies that have made marketplace coverage affordable for 95% of enrollees are set to expire at the end of 2025. Without congressional action, premiums could more than double for many families. A young adult making $35,000 could see their annual premium jump from about $1,000 to over $2,600 overnight.
At the same time, new federal Medicaid requirements threaten to add bureaucratic hurdles that could cause people to lose coverage—not because they're ineligible, but because they couldn't navigate the paperwork.
And Medicare? Part B premiums are jumping 12% in 2026, while new restrictions exclude entire groups of immigrants who've paid into the system for years.
When costs rise and safety nets shrink, understanding your options isn't just helpful—it's essential.
Why I Do This Work
I didn't get into healthcare policy because I love insurance (does anyone?). I got into it because I believe that access to healthcare is a fundamental right, and insurance literacy is part of that access.
Every person deserves to:
Understand what they're paying for
Make informed decisions about their coverage
Navigate the system without fear or confusion
Advocate for themselves when things go wrong
But achieving that requires us—the people who work in this industry—to do better. We need to stop hiding behind jargon and start communicating in plain language. We need to meet people where they are, not where we think they should be.
Breaking Down the Barriers
This is why I've committed to creating accessible educational resources. Whether it's a workshop for young adults learning about insurance for the first time, a mythbusting session to address the confusion around 2026 policy changes, or a one-on-one conversation helping someone choose between plans, the goal is always the same: demystify the system so people can make empowered choices.
I've learned that effective health literacy education requires:
1. Plain Language, Always No more "utilization" when we mean "using healthcare." No more "cost-sharing mechanisms" when we mean "what you pay." If a 6th grader can't understand it, we need to rewrite it.
2. Real Examples Abstract concepts don't stick. But "if you break your arm, here's what you'll actually pay" does. People need concrete scenarios that reflect their lives.
3. Vermont-Specific Context National information is helpful, but people need to know what's happening in their state, with their marketplace, under their laws. Generic advice doesn't cut it when rules vary so dramatically by location.
4. Acknowledging Uncertainty I don't have all the answers, especially right now when policies are in flux. Part of good education is being honest about what we don't know yet and teaching people how to stay informed.
5. Centering Equity Not everyone's healthcare journey looks the same. LGBTQA+ individuals need to know about gender-affirming care coverage. People navigating reproductive decisions need to understand their rights. Immigrants need clarity on how policy changes affect them. One-size-fits-all education fails the people who need help most.
The Ripple Effect
Here's what I've witnessed over the past decade: when you give someone the tools to understand their insurance, the impact extends far beyond that individual.
They share what they've learned with family members. They help a coworker choose a better plan during open enrollment. They advocate more effectively with their doctor's office when there's a billing issue. They vote more informedly on healthcare policy questions.
Health literacy creates a ripple effect. Every person who truly understands their coverage becomes an informal educator in their own community.
A Call to Action for My Fellow Industry Professionals
If you work in healthcare—whether you're in insurance, policy, clinical care, or administration—I have a challenge for you:
Spend one hour this week making something more accessible.
Rewrite a form letter in plain language. Create a FAQ document for a confusing policy. Offer to lead a lunch-and-learn at your organization. Volunteer to help with community enrollment assistance.
We are the gatekeepers of incredibly complex information. We can choose to guard that gate, or we can choose to open it wider.
Looking Ahead
The landscape of healthcare coverage is shifting rapidly, and frankly, it's scary for a lot of people. Misinformation spreads quickly when people are anxious and confused. The best antidote to fear and confusion is clear, accurate, compassionate information.
That's why I'll keep doing this work. That's why I'll keep creating workshops, writing guides, and having patient conversations that start with "there's no such thing as a stupid question."
Because at the end of the day, health insurance isn't really about premiums and deductibles and formularies. It's about people—people who deserve to see a doctor when they're sick, people who deserve to afford their medications, people who deserve to make choices about their own bodies and health without being trapped by incomprehensible fine print.
Making that possible, one educational session at a time? That's work worth doing.
Interested in learning more about health insurance basics or understanding your Vermont coverage options? Check out my workshop series or reach out—I'm always happy to help demystify this complicated system.
References
American Public Health Association. (2024). Health literacy and health equity: The critical connection. APHA Policy Statements. https://www.apha.org/policies-and-advocacy/public-health-policy-statements
Centers for Medicare & Medicaid Services. (2025). Enhanced premium tax credit extension through 2025. U.S. Department of Health and Human Services. Retrieved from https://www.cms.gov
Centers for Medicare & Medicaid Services. (2025). Medicare Part B premium and deductible for 2026. U.S. Department of Health and Human Services. Retrieved from https://www.cms.gov/newsroom
Congressional Budget Office. (2025). Estimated effects of enhanced ACA premium subsidies expiration on marketplace enrollment and premiums. Washington, DC: Author.
Kaiser Family Foundation. (2025). How the expiration of enhanced marketplace subsidies would affect premiums and enrollment in 2026. Retrieved from https://www.kff.org
National Academy of Medicine. (2024). Health literacy: Improving health, health systems, and health policy around the world. NAM Perspectives Discussion Paper. Washington, DC: National Academies Press. https://doi.org/10.31478/202X
U.S. Congress. (2025). Consolidated Appropriations Act of 2025, Pub. L. No. 119-5, 139 Stat. XXX.
U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (2024). Health literacy in Healthy People 2030. Retrieved from https://health.gov/healthypeople/priority-areas/health-literacy-healthy-people-2030
Vermont Department of Financial Regulation. (2025). Understanding your health insurance: A consumer guide. Montpelier, VT: State of Vermont. Retrieved from https://dfr.vermont.gov
Vermont Department of Vermont Health Access. (2025). Green Mountain Care (Medicaid) eligibility guidelines. Waterbury, VT: State of Vermont. Retrieved from https://dvha.vermont.gov
Vermont Health Connect. (2025). 2025 open enrollment: Record savings and enhanced subsidies. Montpelier, VT: State of Vermont. Retrieved from https://healthconnect.vermont.gov
Vermont Legal Aid & Health Care Advocate. (2025). Know your rights: Vermont health insurance consumer protections. Burlington, VT: Authors. Retrieved from https://vtlegalaid.org