Since Congress let ACA premium subsidies lapse and the One Big Beautiful Bill took effect in July 2025, nearly 5 million people lost private coverage in 2026 alone — the steepest single-year drop since the ACA launched, according to the Kaiser Family Foundation. For those who kept their plans, average deductibles hit a record $3,786, up $1,000 in one year. Enrollment could fall to about 17.5 million in 2026, down from 22.3 million in 2025.
The losses will grow. The Congressional Budget Office projects the law’s work requirements will cause 5.3 million people to lose Medicaid by 2034, with Medicaid cuts overall leaving 7.5 million more Americans uninsured. Many won’t lose coverage because they’re ineligible — they’ll lose it because new paperwork requirements are difficult to navigate.
If you’ve lost insurance, seen premiums spike, or had Medicaid disrupted, you’re not out of options. Here are some suggestions:
Check coverage options first. HealthCare.gov (or your state marketplace) lets you check eligibility for a Marketplace plan, Medicaid, or CHIP in one application — you may still qualify for reduced-cost plans even after subsidy changes. Medicaid covers low-income adults, children, pregnant women, and people with disabilities; CHIP covers kids whose families earn slightly too much for Medicaid. If you lost a job, COBRA lets you keep your old employer plan temporarily, though you’ll pay the full premium yourself.
Find affordable providers. Talk openly with your doctor about cost — they can often choose a cheaper test or treatment if they know money is tight, and prices are frequently negotiable. -Federally Qualified Health Centers (FQHCs), like Axis Health, and similar community clinics, offer routine care on a sliding scale based on income.
- Academic medical centers often have strong charity care programs.
- The National Association of Free & Charitable Clinics (nafcclinics.org) helps you find free or low-cost care nearby.
- Avoid the ER when you can — it’s the most expensive option, even though it’s required to stabilize you regardless of ability to pay.
- And know your rights: under the No Surprises Act, uninsured patients are entitled to a good-faith cost estimate, with a dispute process if your bill comes in much higher.
Get affordable medications. Ask your pharmacist directly, they have access to discount programs that aren’t always advertised.
- Comparison sites like GoodRx, WellRx, and SingleCare can help you shop around.
- Walmart, Target, and Costco sell many 90-day generic prescriptions for around $10.
- Cost Plus Drug Company (costplusdrugs.com) offers steep discounts on generics.
- TrumpRx.gov, a federal site launched in 2026, now lists both brand-name and generic drugs at negotiated cash prices — useful mainly if you’re uninsured or paying out of pocket.
- Manufacturer assistance programs, NeedyMeds.org, and state pharmaceutical assistance programs (search your state name plus that phrase) can also help.
Use your local health department. Many counties offer free vaccinations, family planning, and STI, flu, COVID and TB testing, plus sometimes dental or mental health services. The CDC’s National Breast and Cervical Cancer Early Detection Program offers free or low-cost screenings for low-income women nationwide.
Look for diagnosis-specific help.
- The Patient Advocate Foundation (patientadvocate.org) maintains a vetted list of foundations that help with bills, transportation, and lodging based on your diagnosis.
- Disease-specific nonprofits like the American Cancer Society, Susan G. Komen, or the Lupus Foundation can connect you to free or discounted care.
- The NIH and National Cancer Institute list clinical trials that may offer access to treatment — just ask about costs upfront.
Watch for fake insurance. Be wary of plans with too-good-to-be-true premiums, no coverage for pre-existing conditions, morality clauses, or no mental health coverage. Some short-term plans and health-sharing ministries leave people with huge bills exactly when they need help most.
This is a genuinely hard moment, with U.S. healthcare spending up 7.2% in a single year to over $15,000 per person. But, resources exist, and you don’t have to navigate this alone. For a greater detailed Guide, visit here.
Jan Phillips, League of Women Voters La Plata
Chair of Healthcare