Health insurance bills could be hardship for many - Yahoo! News WASHINGTON Many middle-class Americans would still struggle to pay for health insurance despite efforts by President Barack Obama and Democrats to make coverage more affordable. The legislation advancing in Congress would require all Americans to get insurance through an employer, a government program or by buying it themselves. But new tax credits to help with premiums won't go far enough for everyone. Some middle-class families purchasing their own coverage through new insurance exchanges could find it out of reach.