Overall, about 4.4 million fewer people who buy coverage on their own were insured in 2018 compared to 2015, a decline from 18.8 to 14.4 million. (Photo: Shutterstock)

Like millions of Americans in this final week of open enrollment for the Affordable Care Act marketplaces, Diane McCabe is shopping for health insurance.

“At my age, I can't go without it even though I'm healthy now,” said McCabe, 62, a self-employed real estate agent in Luzerne County, Pa. “But the process is frustrating, and the expense significant.”

That's because McCabe is one of the 5 million people who buy their own coverage and pay the full cost. Her income is too high to qualify for a government subsidy to help defray the premium.

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