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. Centers like Axis Health, and similar community clinics offer routine care on a sliding scale based on income.
Get affordable medications. Ask your pharmacist directly; they have access to discount programs that aren’t always advertised.
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.
Watch for fake insurance. Be wary of plans with too-good-to-be-true premiums, no coverage for preexisting 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 more detailed guide, please visit LWVLaPlata.org.
Jan Phillips of Durango is healthcare chair of the League of Women Voters of La Plata County.