What to do if you're losing health insurance in 2026
Health Insurance prices are expected to surge in 2026. Millions of Americans will no longer be able to afford health insurance. They need alternatives that don't rely on government. There are a variety of options, including one secret weapon that people still aren't talking about.
Why are health insurance prices spiking?
Multiple factors are combining during the next year, and will cause a dramatic spike in health insurance prices in 2026 . The federal government has estimated at least 16 million people will become un-insured:
- A tax credit, a subsidy, and an income cap are all expiring December 31, 2025. These American Rescue Plan Act (2021) benefits for ACA marketplace insurance all expire on December 31, 2025. KFF estimates ACA marketplace enrollees will pay an average of 75% more in health insurance premiums. The Congressional Budget Office estimated this would reduce the number of insured by 5.1 million people.
- A work requirement on Medicaid eligibility take effect after June 1, 2026. The One Big Beautiful Bill Act (2025) dictates this must be implemented no later than January 1, 2027. As explained by the American Medical Association, the Act "creates new administrative requirements and conditions on eligibility (including work requirements) for patients seeking to enroll in or maintain Medicaid coverage and restricts states’ ability to use provider taxes to finance their Medicaid programs." The Congressional Budget office estimated this would reduce the number of insured by 10.9 million people.
- Tariffs (taxes) that were substantially increased in 2025 will have made their way through the supply chain. These will particularly impact lower-margin products like generic drugs and common medical supplies. Health system expenses are expected to increase 10-15% across the board. In turn, this is forcing health insurers to increase prices.
- New demand has also put upward pressure on prices, in particular with semaglutide weight-loss drugs like Ozempic. In turn, this is putting upward pressure on health insurer prices.
- Adverse selection will put further upward pressure on prices on an ongoing basis. The spike in prices in 2026 will cause many healthier people to drop their health insurance simply because the high cost will become so detached from the modest benefit. Plus, the ACA penalty has been removed, so they are no longer required to have insurance. As healthier people drop out of the insurance pool, insurers will increase premiums to cover the higher average cost per insured.
What should you do if you can't afford health insurance anymore?
If you expect your health insurance to become unaffordable in 2026, you have a few options.
If you need short-term care for free, even if there are very long wait times:
- Emergency room. Hospitals that accept Medicaid are required to stabilize anyone in an emergency, as dictated by EMTALA.
- Community Health Centers. Federally Qualified Health Centers (FQHCs) may be able to provide some primary and preventive care.
- Charity care. Local hospitals and churches may be able to help provide you with medical care. Reach out to ask.
However, millions of people will be leaning on those resources, so expect long waits if you can get care at all.
If you want longer-term solutions that you can rely on:
- Catastrophic health insurance. Covers only expensive/extreme cases. (This is what insurance should be.)
- Health sharing ministry. "Health shares" are not insurance, because they are not obligated to pay, but they can help with your medical bills.
- Medical cost sharing groups. Similar to a health sharing ministry, but non-religious.
The secret weapon
The most affordable healthcare can only be unlocked through the "self-pay" strategy. It means you pay out of pocket, but you get the lowest possible prices. This approach is usually much less expensive than health insurance.
You can become a "self-pay patient" by asking about self-pay discounts yourself, or by using a service like Pocketero to do it for you.