Selena Simmons-Duffin

Ken Warner and Parveen Vora are in their mid-50s and live in Manchester, Connecticut.

They're self-employed and use the ACA for health coverage.

Last year, they had to drain one of their two small retirement accounts.

To pay for the hip surgery and the eye surgery and the roof went.

We needed a new roof and a new boiler in the same year of the surgery.

Now they're wondering how they can pay for surgery on Vora's other eye and Warner's other hip and eyeing the retirement account that's left.

They say they feel stuck in a broken system, with health care premiums and out-of-pocket costs only getting more expensive each year.

Selina Simmons-Duffin, NPR News.

The Joint Economic Committee in Congress estimates that overpayments to insurance companies that run Medicare Advantage has cost American seniors billions.

Specifically, in 2025, seniors paid $13.4 billion in higher premiums for doctor's office visits and outpatient services.

More than half of those enrolled in Medicare are in one of these private plans.

Republicans in Congress were long champions of the model, but bipartisan criticism has been growing because Medicare Advantage actually costs the government about 20% more per person than traditional Medicare.

Selina Simmons-Duffin, NPR News, Washington.

You're listening to Shortwave from NPR.

Hi, short wavers.

Selena Simmons Duffin in the host chair.

Years ago, I can't remember exactly when, I became aware that gay people are often the youngest kids in their families.

As a gay person who's the youngest in my family, there was something kind of appealing about this idea, like there was a statistical order to things, and I fit neatly into that order.

When I started reporting on the science behind the idea, the whole thing turned out to be much more interesting than I originally imagined.

Also stranger and darker.