The 2026 Healthcare Panic Button: New Alternatives for Individuals & Employers (Feat. Amber Krauza)

In this packed episode, Tom Quigley invites Amber Krauza of CEHAS to help tackle one of the biggest questions hanging over the country right now: “What the hell are people supposed to do when health insurance jumps 40%, 50%, even 60% overnight?”The entire marketplace is in upheaval — open enrollment is a disaster, premiums are skyrocketing, networks are shrinking, and millions of people suddenly can’t afford coverage. Tom and Amber break down real alternatives for both individuals and employers, especially people who are healthy, priced out of the ACA marketplace, and sick of fighting with insurance companies and corrupt state departments of insurance.Amber brings solutions for 40 out of 50 states, while Tom exposes why the system is collapsing — and why employers absolutely must pivot or face financial ruin in 2026.This episode blends hard truth, practical solutions, and Tom’s classic “tell it straight” commentary — plus a few jokes about monkeys, Chicago, Wheaton, and why no one under 30 wants to leave their house anymore.ACA premiums in many areas have risen 40–60%.In some states, networks have collapsed to the point where there’s only one hospital available.Brokers who ignored Amber 6 months ago are now calling her back begging for solutions.Amber breaks down three types of plans for individuals and employer groups:Available in 40 statesNationwide access5–6 strong network choices including:Blue Cross Blue ShieldAetnaCignaFirstHealth/PHCSHealthSmartRates barely moved this year — one plan increased only 3.5%, compared to the marketplace’s 40–50%.Similar to “major medical lite”Lower premiumsFor employers who still want solid coverage but cannot afford traditional plans.Designed to avoid employer mandate penaltiesA workable option for:RestaurantsHospitalityRetailHigh-turnover industriesEnsures employees have basic coverage to keep them compliant.For healthy people willing to roll the dice10 doctor visits per year$1M annual / $5M lifetime maxTelemedicine includedGreat for:Gap monthsNew hiresPeople waiting for MedicarePeople priced out of ACAAmber explains pre-existing condition rules:Only major conditions in the last 5 years trigger a decline.Type 2 diabetes? Accepted.High blood pressure? Accepted.CPAP use? Accepted.Pregnant? Still accepted if enrolled before diagnosis.No SSN required — ITIN / Tax ID is fine.Huge advantage: “Applications submitted by the 18th start the 1st of the next month.”You don’t have to wait for open enrollment.Tom explains why business owners can’t ignore this:Staying with traditional insurance could bankrupt them.MEC or MVP plans can save businesses, especially in industries with:Small marginsHigh employee turnoverLow subsidy qualificationThese plans allow employers to offer something instead of nothing, helping retention.Brokers told clients “Don’t worry, I’ll get you a great deal” — now they’re eating their words.Many are calling Amber for help because their networks disappeared or premiums doubled.Tom:“I could train a chimp to do what most brokers do. Press a few keys, print a spreadsheet, and call it a day.”Amber and Tom both warn:If people can’t afford insurance, hospitals will get crushed.Marketplace access is shrinking.Many states with corrupt insurance departments block competition altogether.Solutions must come from outside the traditional industry.Amber highlights a fascinating shift:Younger people (20s & early 30s) avoid doctors, offices, or anything requiring in-person visits.They love:TelemedicineLinksOnline enrollmentZero paperworkMeanwhile older generations still want paper forms and face-to-face meetings.If you’re healthy but can’t afford ACA premiums:Amber’s plans are a strong alternative.If you’re an employer getting crushed by 2026 renewals:Consider MVP or MEC options to keep your business afloat.If you’re between jobs or waiting for Medicare:Limited medical plans can provide safe temporary coverage.