Shock and dismay have already begun as Americans face next year’s health insurance costs—and it looks like everyone will be in for some grim numbers.
So far, much of the attention has been on the stratospheric prices that Americans might see on plans they buy from Affordable Care Act marketplaces. Critical tax credits for those plans are set to expire at the end of the year, and, on top of that, insurers have proposed a median 18 percent price increase for 2026. With the higher prices and a loss of credits, some Americans could see their monthly premiums more than double.
The biggest thing insurance does is limits risk. When you have insurance and get a big hospital bill, you generally have more bargaining power with the hospital than if you don’t have insurance. When enrollment time comes run the numbers and look at the costs. You can also apply and review options on the health insurance marketplace which usually involves applying for Medicaid in the process. For kids under 18 Medicaid has a family income cap of like $8k/month so if you have kids they’re definitely covered by Medicaid
Personally, I’m not sure what I’m going to do in 2026 if the subsidy isn’t renewed. I’m an independent contractor so my health insurance options are entirely limited to the marketplace, and while I currently have a plan that costs $1250/month with the $1100/month subsidy I only pay $150/month for insurance which is quite reasonable. Every plan I saw on the marketplace cost a minimum of $900 or more per month.
I simply do not make enough (and I’m not allowed to work more hours than I currently am so that’s not an option) to be able to afford insurance if the above math is the same for 2026. My plan right now is, keep job hunting and maybe my wife starts job hunting too since my contract work can work around the kids’ school schedules (and my youngest starts going to school full time next year rather than half time) so we don’t need a non-working parent as long as this contracting lasts for, and we probably won’t get coverage through the marketplace in 2026 unless I can get it for about $400/month or less, because at that point I’m probably better off risking dumping more money into my emergency fund and hoping we don’t have any medical emergencies (and planning on negotiating with the hospital if we do) I don’t like the risk level of no insurance but we may simply be priced out of having insurance if the healthcare marketplace subsidy isn’t renewed
“Bargaining power with the hospital” might be the most dystopian thing I’ve ever heard in my life.
Oh hospital billing is absolutely fucked up. Usually the bill you receive isn’t itemized and simply requesting an itemized bill can be enough to knock some amoint off of the bill because even the hospitals billing staff are often not entirely certain exactly how they got that number they’re now billing you for.
But yeah, anyone who does receive a large hospital bill, engage in some negotiations, ask for an itemized bill, state you will be paying the lower amount that is billed to insurance, advise that you’re in a tough financial spot and ask what discounts or community care programs are available, and once all of that is done ask if you can settle for a lower amount by paying as a lump sum. My youngest’s birth resulted in an $8k bill and ultimately the entire bill went away after a community care application (there were also some other unpaid bills that got forgiven because this hospital is horrible about actually sending bills, only ever sending statements that clearly say “this is not a bill” on them) so definitely use that bill as a starting point for negotiations!
Yeah, uh… We don’t do any of that. Last time I was in a hospital my main concern was driving back to a different province with a bandage on my hand.
The only time I’ve ever paid anything for a hospital stay, other than prescription meds, is when I had to cover $40 for an ambulance call-out. And I billed that to my work because it was a workplace injury.
Look, I’m not trying to twist the knife here, I just really wish every American understood how completely insane their system is. It doesn’t have to work like that. The words “negotiate with the hospital” do not ever have to be a part of your life.