Expired Subsidies? 5 Alternative Low-Cost Plans to Avoid Going Uninsured -

When premium tax credits fade away, millions of families face sticker shock come renewal season. Enhanced subsidies enacted under the American Rescue Plan Act (ARPA) and extended by the Inflation Reduction Act (IRA) have kept average Marketplace premiums as low as $113/month for many enrollees—down from around $619/month before 2021 (barrons.com). But with those enhanced subsidies set to expire on December 31, 2025, what can you do to avoid losing coverage or plunging yourself into financial uncertainty?

Fortunately, you’re not stuck between sky-high premiums and going without insurance. Below, we explore five viable alternatives—from government programs to new care models—that can keep you covered at a fraction of the cost.

Why Subsidies Are Ending (and What It Means for You)

Temporary nature of ARPA/IRA subsidies. The American Rescue Plan Act originally provided two years of enhanced premium tax credits (2021–2022). The Inflation Reduction Act extended those enhancements through 2025, reducing net premiums by an average of 44% for Marketplace enrollees (kff.org).
Impact of subsidy expiration. Without enhanced subsidies, premiums could more than double in many states, pricing out up to 1.5 million middle-income Americans currently benefiting from tax credits (kff.org).
Projected coverage losses. Analysts estimate that up to 4.2 million people may forgo coverage entirely by 2034 if subsidies vanish, with spikes in uninsurance rates especially among those just above subsidy-eligibility thresholds (barrons.com).

As you prepare for potentially higher costs in 2026 and beyond, consider these five low-cost options to bridge the gap and stay protected.

1. Medicaid & CHIP (Low or No Premiums)

Medicaid and the Children’s Health Insurance Program (CHIP) remain the gold standard for free or nearly free coverage—if you qualify.

Who’s eligible? Income thresholds vary by state, but many families earning up to 138% of the Federal Poverty Level (FPL) qualify for Medicaid. CHIP covers children in families earning above the Medicaid cutoff but below higher state-determined limits.
Key benefits: Comprehensive coverage including doctor visits, hospital stays, prescription drugs, and preventive care, with little to no cost‐sharing.
How to enroll: Visit your state’s Medicaid website or HealthCare.gov and complete the application. Enrollment is year‐round for Medicaid/CHIP if you qualify.

“Medicaid covered nearly 79 million people nationwide as of December 2024, making it the largest source of health insurance in the U.S.” (goodrx.com).

If your income dips or you have children, this may be the easiest path to comprehensive coverage at minimal cost.

2. Catastrophic Health Plans (Affordable Safety Net)

For generally healthy adults under age 30 (or those with a hardship exemption), catastrophic plans offer a low monthly premium in exchange for high deductibles.

Eligibility: Under 30 years old, or waiver based on a financial hardship or certain life events.
Coverage highlights:
- Preventive services covered at 100%.
- Very low premiums (often $100–$200/month).
- High deductibles (approximately $9,000+ in 2025).
Who it’s for: Healthy individuals seeking protection against worst-case scenarios without paying full premium prices.

Catastrophic plans won’t cover routine care until you meet the deductible, but they can protect you from devastating medical bills at a fraction of the Marketplace premium.

3. Short-Term Limited Duration Insurance (Temporary Bridge)

Short-term plans are designed to fill coverage gaps—perfect if you’re between jobs, waiting for open enrollment, or just need immediate protection.

Feature	Short-Term Plan
Monthly Premium	$50–$250
Deductible	$2,500–$10,000
Coverage Duration	Up to 12 months (state dependent)
Pre-existing Conditions	Usually not covered
Network	Limited provider networks

Pros: Very low premiums; speedy approval (often within 24 hours).
Cons: May exclude coverage for pre-existing conditions, preventive care, and essential health benefits required under ACA plans.

For short stints without other options, these plans buy you time until you can enroll in a more comprehensive plan during the next open season.

4. Health Sharing Ministries (Community-Funded Plans)

Health sharing ministries aren’t insurance, but they can be an affordable alternative where members share medical costs.

How it works: Members contribute a monthly “share” into a communal pool, which pays for eligible medical expenses of other members.
Average cost: $150–$300/month, depending on age and plan type.
Key limitations:
- Not regulated as insurance—no guaranteed payment.
- Certain conditions (e.g., pre-existing conditions, mental health, substance abuse) may be excluded or have waiting periods.
Good fit for: Individuals seeking low-cost, faith-based solutions and willing to accept some risk of cost-sharing variability.

“Health sharing plans can be up to 30–40% cheaper than comparable ACA plans, though they may limit coverage for pre-existing conditions and preventive services.” (forbes.com).

5. Direct Primary Care (DPC) + High-Deductible Plan

Pairing a Direct Primary Care membership with a high-deductible health plan (HDHP) can yield predictable primary care costs and catastrophic protection.

Direct Primary Care:
- Monthly membership: $50–$100 for unlimited office visits and basic labs.
- Benefits: No co-pays for routine visits; strong patient–doctor relationship; transparent pricing.
HDHP:
- Catastrophic coverage: Covers major events once the deductible ($3,000–$6,000) is met.
- HSA eligibility: Contributions reduce taxable income and can pay for qualified medical expenses tax-free.

This combination balances affordable, predictable primary care costs with emergency coverage for unexpected events—often at a lower total cost than standard Marketplace bronze or silver plans.

Quick Comparison Table

Plan Type	Estimated Premium*	Deductible Range	Preventive Care	Pre-existing Coverage	Ideal For
Medicaid/CHIP	$0–$25	$0–$200	✔️ Fully covered	✔️ Yes	Low-income individuals and families
Catastrophic Plan	$100–$200	$8,000–$10,000	✔️ Covered	✔️ Yes	Under 30 / hardship waiver
Short-Term Insurance	$50–$250	$2,500–$10,000	❌ Limited	❌ No	Temporary gaps in coverage
Health Sharing Ministry	$150–$300	Varies	❌ Often excluded	❌ Restricted	Faith-based cost-sharing community
DPC + HDHP (with HSA)	$100–$200 (DPC) + $50–$150 (HDHP)	$3,000–$6,000	✔️ DPC covers	✔️ Yes	Those seeking unlimited primary care & HSA benefit

*Premium estimates per adult; actual costs vary by age, location, and provider.

Making the Best Choice for Your Situation

When subsidies expire, there’s no one-size-fits-all solution. Here’s how to decide:

Assess your budget. Determine how much you can afford monthly—not just average premiums but worst-case out-of-pocket costs.
Evaluate your health needs. If you’re generally healthy, catastrophic or short-term plans may suffice. If you have chronic conditions, Medicaid/CHIP or HDHP+DPC could be better.
Check eligibility. Verify income limits for Medicaid/CHIP and catastrophic plans, and state regulations on short-term duration.
Factor in network access. Ensure your preferred doctors and hospitals are in-network, especially for short-term and catastrophic plans with limited provider networks.
Consider flexibility. Health sharing ministries and DPC plans can offer unique benefits, but come with trade-offs—make sure you understand membership rules and coverage exclusions.

Final Thoughts: Staying Covered Without Breaking the Bank

The looming end of enhanced Marketplace subsidies doesn’t have to mean going uninsured. By understanding your options—whether it’s tapping into Medicaid, opting for a high-deductible catastrophic plan, or exploring innovative models like direct primary care—you can secure coverage that aligns with your financial and health needs.

Remember to:

Compare plans annually. Premiums, deductibles, and network providers can change.
Consider professional advice. A licensed broker or Marketplace navigator can help you navigate complexities, especially during enrollment.
Plan for emergencies. Even low-cost plans should shield you from catastrophic medical bills.

With thoughtful research and timely action, you’ll avoid the coverage cliff in 2026—and keep peace of mind knowing you have a plan that fits both your wallet and wellness goals