Full Breakdown
Americans Face a “Wild West” of Health-Insurance Choices After Leaving the ACA Marketplace
By Drooid · · How we work
Surge in ACA Premiums Drives Dropouts
In 2026, roughly 3 million people left the Affordable Care Act (ACA) marketplace after the expiration of enhanced COVID-era premium tax credits caused sharp cost increases. Insurers have proposed a median premium rise of about 15 percent for 2027, marking the second consecutive year of double-digit hikes, according to health-policy research group KFF. The ACA plans covered 19.2 million people as of February, according to government data. Enrollment for ACA plans opens November 1 and runs until January 15.
Turn to Short-Term Plans and Health-Sharing Programs
Many former ACA enrollees have switched to short-term health plans that are cheaper but less comprehensive. Ryan Shapiro, a photographer from Frederick, Maryland, dropped his ACA coverage when his premium would have exceeded $1,000 per month and opted for a short-term plan costing roughly $600 monthly. Under current federal rules, short-term plans are generally limited to three months plus a one-month renewal, though the U.S. Centers for Medicare & Medicaid Services (CMS) indicated it would stop enforcing that limit, allowing some states to permit longer coverage.
Others have joined health-sharing programs, which pool members’ contributions to cover medical expenses but lack consumer protections. Cristin Connelly of Atlanta pays $480 per month for a Zion HealthShare plan that includes annual preventive visits and a mammogram, yet requires a $5,000 minimum spend before the community pool contributes.
Consequences for Preventive Care and Hospital Costs
High deductibles and limited coverage have led many to postpone or skip preventive services. Stacy Cox, a self-employed photographer in Kanab, Utah, faces a $1,200 mammogram cost and has delayed cancer screenings. Hospital operators such as Universal Health Services, a Pennsylvania-based system with more than 500 facilities, report rising expenses treating patients who are now uninsured after dropping ACA coverage.
Official Statements & Responses
The spokesperson emphasized that these products are “one of several options available.”
Verbatim Quotes
- “It's half the cost of full-blown health insurance,” — Ryan Shapiro
- “There really and truly is a bit of a wild, wild West out there with respect to these products," Corlette said.” — Sabrina Corlette