Americans Turn to Costlier Alternatives as Obamacare Coverage Becomes Unaffordable

Rising premiums and deductibles are pushing millions of Americans out of Affordable Care Act marketplace plans, leaving many to seek cheaper but less comprehensive alternatives or go without insurance. Self-employed photographer Stacy Cox, 49, of Kanab, Utah, dropped her Obamacare plan this year and now faces a $1,200 mammogram bill. Cox, who has a family history of breast cancer and requires regular medication for an autoimmune disease, said healthcare costs have forced her to question whether she can continue operating her business.

About 3 million Americans have left the ACA marketplace amid sharp increases in premiums and deductibles in 2026, according to the report. The marketplace covered 19.2 million people as of February, while the expiration of enhanced COVID-era premium tax credits contributed to higher costs. Some consumers have shifted to short-term insurance or health-sharing programs, while others have postponed preventive care and medical treatment. Photographer Ryan Shapiro, 56, said he replaced an ACA plan costing more than $1,000 a month with a short-term policy costing about $600, while planning to wind down his photography business.

Health policy experts warn that cheaper alternatives can come with significant limitations and fewer consumer protections. Health-sharing programs may require members to pay substantial amounts before expenses become eligible for sharing, while short-term plans generally provide narrower coverage. Meanwhile, insurers have proposed a median 15% premium increase for ACA marketplace plans for 2027, according to KFF. Open enrollment for ACA plans is scheduled to run from November 1 through January 15, adding to concerns among consumers already struggling to balance healthcare costs with household and business expenses.

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