The Reiters buy their own coverage, but they earn too much to qualify for financial aid to lower their monthly premiums. For 2017, they bought a plan off the exchange and paid $26,000 in premiums for family coverage, including their two sons, ages 21 and 17.

Keeping the same coverage for 2018 would have cost the Reiters $40,000 in premiums, a 54 percent increase. So they selected a lower-priced plan that covers less but costs $29,000 in premiums.

“That’s more than a lot of people’s mortgage payments,” Richard Reiter said. “For me, it’s a crisis situation.”