Rising premiums are pushing consumers to reconsider coverage but going without it comes with real risks
April 27, 2026
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Rising health insurance premiums are pushing more Americans to question whether they can afford to keep coverage or go without it entirely.
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Online searches for cheap and lower-premium plans are surging, signaling growing financial strain and shifting consumer behavior.
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Experts warn that going uninsured can come with penalties in some states and serious financial risks, but there may still be ways to lower costs and stay covered.
As health insurance premiums climb, more consumers are starting to ask a question that once felt unthinkable: Can I afford to go without coverage altogether?
New data from healthinsurance.org suggests this isnt just a passing concern its part of a broader shift in how people are responding to higher costs.
ConsumerAffairs spoke with Louise Norris, a health policy analyst at healthinsurance.org, who explained that these trends reflect mounting financial pressure but also some confusion about what going uninsured actually means. While skipping coverage might seem like a way to save money in the short term, there are still potential penalties in some states and significant financial risks if something goes wrong.
The current state of the health care market
The report from healthinsurance.org found that there has been a recent surge in search terms like "cheap health insurance" and "catastrophic health insurance."
This is indicative of a market where people are struggling with the premiums they have to pay to maintain their coverage, Norris said. The expiration of federal subsidy enhancements caused sticker shock that people began to experience last fall when they got their renewal notices for their Marketplace coverage.
Search interest in these terms has continued to grow sharply in early 2026, which could stem from the fact that nearly 9 million people let their Marketplace coverage auto-renew for 2026. Some of these enrollees might not have been aware of how much their net premiums would increase in 2026, leading to increased search interest for lower-cost coverage after the start of the year.
Driving premiums higher
Over the next several weeks, health insurance plans will be filing their proposed rates and plans for 2027 coverage. What does this mean for the future?
We haven't yet seen the proposed rates that carriers will be filing, Norris said. So a lot remains to be seen, but we do know that the individual market has a smaller overall risk pool this year, and that's expected to shrink even more once we see effectuated enrollment numbers.
And in general, it tends to be healthier people who are most likely to drop their coverage when premiums rise, leaving a smaller, less healthy pool of insureds. Over time, this will tend to drive premiums higher.
Penalties for going uninsured
For those who opt to go without health insurance, there could be consequences. Many states will leave consumers with a financial penalty for being uninsured.
Norris broke it all down:
There is a penalty in New Jersey, DC, Massachusetts, California, and Rhode Island, she said. But California, New Jersey, and Massachusetts all offer state-funded subsidies, in addition to federal subsidies, to make coverage more affordable. And DC has a Basic Health Program for residents with income up to 200% of the federal poverty level.
So in general, most of the states that have a penalty for being uninsured are also states that have worked to make coverage more accessible to people. All of these states have had penalties for at least several years now, so most residents are likely aware that health coverage is part of the state tax return.
Advice for Marketplace enrollees
For those who currently have Marketplace coverage and are struggling to keep up with payments but dont want to go uninsured, you have options.
It's important to understand that contributions to a pre-tax retirement account and/or an HSA (if you have HSA-eligible coverage, which now includes all Bronze and Catastrophic plans) will reduce household income, potentially making [you] eligible for larger subsidies or helping avoid the subsidy cliff, Norris said.