Lost your ACA coverage because premiums went up? Here’s what to do next

If your Affordable Care Act (ACA) plan suddenly feels unaffordable, or you’ve already lost coverage because subsidies were reduced or eliminated, you’re not alone. Millions of Americans are confronting higher monthly premiums as enhanced subsidies expire, or income changes affect eligibility. While the sticker shock is real, losing an ACA subsidy doesn’t mean you’re out of options.

There are a few key steps you can take to protect yourself from going uninsured.

But before you start comparing plans or switching coverage, it’s important to understand why your ACA costs changed in the first place. Most subsidy disruptions fall into one of three categories:

• Your income changed, pushing you above the subsidy threshold
• Temporary enhanced subsidies expired, increasing your share of the premium
• Your application wasn’t updated or re-enrolled, which can default you into a full-price plan
  

Log into your Health Insurance Marketplace account and confirm what’s changed. This step matters more than it seems and the reason behind the change can open (or close) specific coverage options.

A loss of subsidies or a sharp premium increase may also qualify you for a Special Enrollment Period (SEP), even outside Open Enrollment. If eligible, you typically have 60 days from when coverage became unaffordable or ended to enroll in a new plan. Waiting too long can limit your choices, so timing is critical.

Option 1: Re-shop ACA plans 

Even if your current plan jumped in price, other ACA plans may still be within reach — but not all of them will be a good financial fit. Premiums, deductibles, and provider networks can vary widely, even within the same metal tier. That’s why comparing options matters.

What to check:

• Lower cost Bronze or Silver plans
• Plans from different carriers in your area
• Networks that better match how you actually use care

Many consumers overpay simply because they stick with a plan that no longer fits. Comparing plans helps you rule out unaffordable options quickly and zero in on plans that deliver real savings without sacrificing the coverage you rely on.

Option 2: See if Medicaid is an option

If your income dropped, or fluctuates, you may now qualify for Medicaid, even if you didn’t before.

Medicaid offers:

• Very low or no monthly premiums
• Comprehensive benefits
• No Open Enrollment restrictions

Eligibility rules vary by state, but it’s absolutely worth checking before ruling it out.

Option 3: Consider short-term or alternative coverage carefully

For some consumers, short-term health insurance or other non-ACA plans can serve as a temporary bridge.

There are some important caveats to know about short-term health insurance:

• Pre-existing conditions often aren’t covered, which means care tied to past or ongoing health issues may be fully out of pocket
• Benefits are narrower, with limits on things like prescriptions, mental health care, maternity services, or preventive care
• Out-of-pocket costs can add up quickly if you need care beyond basic services
• Coverage is temporary by design and isn’t a long-term substitute for ACA-compliant insurance

This option can make sense if you’re between jobs, waiting for Open Enrollment, or expecting income changes, but only if you’re comfortable trading comprehensive coverage for short-term affordability and understand exactly what isn’t covered.

Option 4: Employer or spousal coverage may be your best move

If your ACA plan has become unaffordable, it’s worth taking a fresh look at coverage through work or a spouse or partner. In many cases, these plans offer more predictable costs and broader benefits than what you’d find on the individual market.

You may newly qualify for:

• Employer-sponsored insurance, especially if a change in income or subsidy eligibility affects your ACA costs
• Coverage through a spouse or partner, even if you previously declined it

Losing ACA subsidies or experiencing a meaningful cost increase can sometimes trigger special enrollment windows for employer or spousal plans, too. That makes timing important. Acting quickly helps ensure you don’t miss a limited opportunity to switch into coverage that may offer better value and long-term stability.

Why going without coverage is the riskiest choice

Medical debt remains one of the leading causes of financial hardship in the U.S., and it often starts with a single, unexpected event, such as an ER visit, a short hospital stay, or an urgent procedure. Costs can escalate quickly, even for people who are otherwise healthy.

While no plan is perfect, having some coverage provides a financial backstop that protects your savings and limits worst-case outcomes. In most cases, even a basic or temporary plan is far safer than hoping nothing goes wrong.

The bottom line

Losing ACA subsidies is frustrating, but it’s not the end of the road. The system is complex, but there are paths forward if you act deliberately and on time.

The most important steps:

• Confirm what changed and why your subsidy was adjusted
• Check whether you qualify for a Special Enrollment Period, so you don’t miss limited switching windows
• Compare all available coverage options, not just the plan you’re leaving or the lowest monthly premium

Health coverage decisions shouldn’t be rushed, but they also can’t be ignored. With the right guidance and a clear understanding of your options, you can still find coverage that protects both your health and your finances.