10 Million Americans Will Lose Health Insurance by 2034 — Here’s What It’ll Cost Them
Written by
Angela Mae
Edited by
Levi Leidy
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As a result of the One Big Beautiful Bill Act (OBBBA), the Congressional Budget Office estimates that the number of uninsured Americans will increase by 10 million by 2034. A key reason for this is the OBBBA’s call for around a $1 trillion reduction in federal spending for Health Insurance Marketplaces and state-administered Medicaid.
So, how will this affect the American people? And how much will losing their health insurance cost them? Here’s what you need to know.
Health Insurance Premiums Will Rise
Since 2014, the premium tax credit (PTC) has helped offset the cost of premiums for qualified health plans found through health insurance exchanges. The PTC has since been expanded and enhanced, allowing more people to become eligible for greater subsidies until the end of 2025.
With these subsidies set to expire, the Congressional Budget Office (CBO) predicts the following:
- Fewer people will enroll in subsidized exchange coverage (which will lower federal expenditure)
- More people will become uninsured
Not only that but not extending these premium tax credits throughout 2026 could lead to health insurance companies increasing gross benchmark premiums by an average of 4.3% for the year. If the PTC is never extended again, these premiums could increase by an average of 7.9% every year from 2026 to 2034.
The Urban Institute estimates the average annual premium for those with a subsidized Marketplace plan is $460 in 2025. Without the enhanced tax credit, that price would have been $1,087 — a 136% increase.
With a 4.3% increase expected next year, that $1,087 would be $1,134.
Out-of-Pocket Costs Could Skyrocket
According to the Kaiser Family Foundation (KFF), more than 24 million people are enrolled in a Marketplace plan. An estimated 92% of enrollees receive an advance premium tax credit (APTC).
Losing this credit won’t just affect premiums. For low- and moderate-income people, especially those who decide to forego health insurance due to unaffordable premiums, a surprise visit to the hospital — or even a routine checkup — could mean substantially more out of pocket.
Last year, the Milliman Medical Index found that the average employee spends more than $1,100 annually on out-of-pocket healthcare expenses. This is beyond their typical health insurance costs.
Without insurance, out-of-pocket costs could be hundreds or even thousands of dollars. According to Advent Health, a simple visit to a primary care doctor can range from $150 to $300. An X-ray can easily exceed $1,000. Major procedures can be much higher than that.
Medical Bankruptcies Could Cost Americans Thousands
The KFF reports that nearly half of U.S. adults wouldn’t be able to pay even a $500 medical bill out of pocket. This isn’t limited to lower-income households, though the percentage increases in the lower-income tiers.
Unpaid medical bills often end up in collections. A study on medical debt and collections in the United States found that 36% of U.S. households have medical debt. Just over a fifth of consumers have a past-due medical bill. The mean total medical debt in collections ranges from $2,456 and $7,931.
Debt in collections often goes unpaid and, in some cases, leads to bankruptcy filings.
“If people go without health insurance, not only will they not be getting the healthcare that is needed but there is an increased risk of bankruptcy likely from a financial standpoint if they have unpaid medical bills,” said Ryan Brown, the CEO and founder of Essential Benefit Administrators.
Another study from a few years ago found that nearly 67% of people who filed for bankruptcy did so in large part because of medical bills. Bankruptcy itself is a costly process. According to Upsolve, it typically ranges from $400 to $3,000.
This isn’t to say that every uninsured American will end up facing such financial struggle. However, the lack of health insurance could — and often has — led to major budgetary strain.
If you or someone you know loses healthcare coverage due to policy changes, there are options.
“If someone cannot afford healthcare, there are many less expensive high-value options for employers to provide their employees such as offering minimum essential coverage/minimum value (MEC/MV) plans,” said Brown.
According to Brown, these options may range from under $100 to under $700 with major national networks like First Health and Cigna. Speak with your employer or health insurance broker to find out more.
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