When Stacy Cox, a 49‑year‑old photographer in Kanab, Utah, dropped her Affordable Care Act (ACA) health plan this year, she faced a stark choice: pay $1,200 for a mammogram or risk the survival of her business. “It’s scary,” Cox told Reuters. “Every month we come to the table and we have a discussion. Is it time to close a business? Is it time to seek employment somewhere in the hopes of gaining health insurance?”

Cox, who has a family history of breast cancer and an autoimmune disease requiring regular medication, is among roughly three million Americans who left the ACA marketplace after premium and deductible hikes at the start of 2026. The marketplace, created under President Barack Obama and commonly called Obamacare, covered 19.2 million people as of February, according to government data. The expiration of enhanced COVID‑era premium tax credits contributed to the surge in costs.

Turn to Short‑Term Coverage and Health‑Sharing Programs

Many former ACA enrollees have shifted to short‑term health plans that offer limited benefits. Ryan Shapiro, 56, from Frederick, Maryland, abandoned his ACA coverage when his premium was set to more than double to over $1,000 a month. He now pays roughly $600 a month for a short‑term plan that covers hospitalization and critical illnesses. Under current federal rules, such plans are generally limited to three months, with a one‑month renewal option. After the Centers for Medicare & Medicaid Services (CMS) announced it would stop enforcing that limit last year, several states have allowed longer coverage periods.

Short‑term plans are marketed as a way to “minimize expenses should a health crisis happen,” Shapiro said. However, they typically exclude many essential services, leaving enrollees vulnerable to high out‑of‑pocket costs for routine and preventive care.

Impact on Preventive Care

Both Cox and other interviewees reported postponing or skipping preventive services, such as cancer screenings and annual checkups, because of unaffordable premiums and deductibles. “What do we do if one of us gets sick? Do we just die? Because we sure can’t afford to fight it,” Cox asked, highlighting the anxiety many face when forced to choose between health and financial stability.

High deductibles compound the problem, requiring patients to pay thousands of dollars before insurance coverage activates. Some respondents also noted limited provider networks under their new plans.

Faith‑Based Health‑Sharing Arrangements

Health‑sharing programs, often organized by religious groups, have attracted those seeking a community‑based alternative. 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 adult children, receiving an annual preventive visit for each family member, one mammogram per year, and a colonoscopy every other year. Zion, which has more than 78,000 active members, imposes a $5,000 minimum spend before members can share expenses, effectively acting as a high deductible.

While Connelly praised the lower cost and reduced claim denials, she acknowledged the lack of consumer protections compared with traditional insurance.

Hospital Operators Feel the Strain

Hospital systems are reporting rising costs tied to treating uninsured patients. Universal Health Services, a Pennsylvania‑based network with over 500 facilities, noted that many patients who left ACA coverage are now uninsured, increasing uncompensated care burdens.

Enrollment data for short‑term plans remain limited, making it difficult to gauge the full scope of the shift.

Future Premium Outlook

Health‑policy research group KFF projects a median premium increase of about 15 % for ACA plans in 2027, marking the second consecutive year of double‑digit hikes. Enrollment for ACA plans opens November 1 and runs until January 15, with major insurers such as UnitedHealth, Elevance, Centene, and Molina Healthcare offering marketplace options.

Experts warn that many states lack robust oversight of aggressive marketing practices for non‑traditional products, leaving consumers vulnerable. “There really is a bit of a wild, wild West out there with respect to these products,” said Sabrina Corlette, a research professor at Georgetown University’s Center on Health Insurance Reforms. “Some of them are legit, some of them not so legit—very much buyer beware!”

Original reporting: Appleton, WI News Feed (HLL/CB) — read the source article.