Americans Turn to Short-Term Plans and Health Shares as Obamacare Costs Climb

Roughly 3 million Americans have exited health insurance plans sold under the Affordable Care Act, widely known as Obamacare, following sharp increases in premiums and deductibles at the start of 2026. The marketplace plans, which offer income-based subsidies, covered 19.2 million people as of February, according to government data. The lapse of enhanced COVID-era premium tax credits at the beginning of the year drove costs sharply higher.

Many of those who left have moved into short-term health plans offering narrower coverage, joined health-sharing programs in which members pool monthly contributions to cover one another's medical bills, or opted to go without insurance altogether — the very gap the ACA was designed to close.

Stacy Cox, a 49-year-old self-employed photographer in Kanab, Utah, dropped her ACA plan this year and now faces difficult choices. At high risk of breast cancer because of family history and managing an autoimmune condition that requires regular medication, she has skipped routine cancer screenings. She described weighing the cost of a mammogram, about $1,200, against keeping her business afloat. "Every month we come to the table and we have a discussion," she said, adding that she and her family ask whether it is time to close the business or seek employment elsewhere in hopes of gaining health insurance.

Ryan Shapiro, 56, of Frederick, Maryland, plans to wind down his photography business by the end of the year and help run his wife's interior design firm, partly because of healthcare costs. His monthly ACA premium was set to more than double to over $1,000, so he switched to a short-term plan costing about $600 a month that covers hospitalization and critical illnesses. "It's half the cost of full-blown health insurance," he said, describing it as a way to limit expenses if a health crisis occurs.

Under current federal rules, short-term plans are generally capped at three months plus a one-month renewal. After the Centers for Medicare & Medicaid Services said last year it would stop enforcing that limit, several states began allowing longer coverage periods. A CMS spokesperson said such plans are primarily meant to bridge temporary coverage gaps, such as a transition from an employer-based plan, and are among several options available.

Enrollment data for short-term coverage remains limited. Insurers have proposed a median premium increase of about 15% for ACA marketplace plans in 2027, according to the health policy research group KFF — a second consecutive year of double-digit increases. Open enrollment runs from November 1 to January 15. UnitedHealth, Elevance, Centene and Molina Healthcare offer Obamacare plans, and some insurers, including UnitedHealth, also sell short-term coverage.

Several hospital operators have flagged rising costs tied to treating uninsured patients. Universal Health Services, a Pennsylvania-based system with more than 500 facilities, said in July that most patients who had dropped ACA coverage appeared to be uninsured.

Those interviewed described postponing or skipping preventive care, annual checkups and other treatment because of high premiums and deductibles, paying out of pocket for urgent care when needed. High deductibles force patients to cover thousands of dollars before insurance begins paying, and some said their plans offered a narrow choice of doctors.

Some have turned to health-sharing programs, often organized by religious groups, which typically lack consumer protections. Cristin Connelly, a 53-year-old public relations consultant in Atlanta, joined Zion HealthShare in 2025 after dropping her ACA plan. She pays $480 a month for herself and her young adult children, a plan that includes an annual preventive visit for each family member, one mammogram a year and a colonoscopy every other year, among other services. It carries a minimum spend of $5,000 before expenses become eligible for the community sharing pool — a de facto deductible Zion calls an initial unshareable amount. Zion HealthShare, which has more than 78,000 active members, has no religious requirements. Connelly said her experience with insurance had been marked by denied claims and partial payments, while her health share has so far offered lower self-pay rates. She hopes to move off the health share eventually.

Experts warn that health-sharing arrangements and other non-traditional products carry significant limitations. Sabrina Corlette, a research professor at Georgetown University's Center on Health Insurance Reforms, said many states do not adequately police aggressive or deceptive marketing, leaving consumers exposed. "There really and truly is a bit of a wild, wild West out there with respect to these products," she said. "Some of them are legit, some of them not so legit, very much buyer beware!"