Key facts
- Approximately 3 million Americans have left the Affordable Care Act marketplace.
- Rising premiums and deductibles are driving people away from ACA plans.
- Some individuals are opting for short-term health plans or health-sharing programs.
- Many have chosen to forgo health insurance entirely.
- Hospital operators are reporting increased costs due to treating uninsured patients.
- Short-term health plans are generally limited to three months under federal rules, though some states allow longer durations.
Millions of Americans are navigating a complex and often less comprehensive health insurance landscape after leaving Affordable Care Act (ACA) marketplace plans, driven by escalating premiums and deductibles. Many are turning to skimpy, short-term health plans or health-sharing programs, while others have opted to go without insurance altogether.
Stacy Cox, a 49-year-old self-employed photographer in Utah, is among those who dropped her Obamacare plan this year due to sharp cost increases, partly attributed to the expiration of enhanced COVID-era premium tax credits. She now faces difficult choices, such as weighing the $1,200 cost of a mammogram against her business's survival, especially given her family history of breast cancer and an autoimmune disease requiring regular medication.
Ryan Shapiro, 56, from Maryland, plans to close his photography business due to rising healthcare costs. His monthly ACA premium was set to more than double to over $1,000, leading him to switch to a short-term plan costing around $600 a month, which covers hospitalization and critical illnesses. These short-term plans, generally limited to three months by federal rules, are seen as a way to minimize expenses in case of a health crisis, though several states now permit longer coverage durations.
Many individuals interviewed reported postponing or skipping preventive care and other treatments due to high premiums and deductibles, resorting to out-of-pocket payments for urgent needs. Cristin Connelly, a 53-year-old consultant in Atlanta, joined Zion HealthShare, a health-sharing program, after dropping her ACA plan. She pays $480 monthly for herself and her young adult children, which includes some preventive care services. Zion HealthShare has over 78,000 members and a minimum spend of $5,000 before medical expenses are eligible for the community sharing pool.
Experts caution that health-sharing arrangements and other non-traditional products have significant limitations and may lack consumer protections. Sabrina Corlette, a research professor at Georgetown University, described the market for these products as a "wild, wild West," with varying degrees of legitimacy and a strong "buyer beware" sentiment. Hospital operators, including Universal Health Services, have also flagged rising costs associated with treating uninsured patients who previously had ACA coverage.