Health policy changes in Washington will ripple through the country, resulting in millions of Americans losing their Medicaid or Affordable Care Act coverage. Still, there are ways to find care.
Over the next decade, the GOPβs One Big Beautiful Bill Act is expected to slash nearly $1 trillion in spending from Medicaid, the state-federal program for people with low incomes and disabilities. The implementation of new work rules will cause some beneficiaries to lose their Medicaid coverage.
Millions of Americans face enormous increases in their out-of-pocket costs for ACA coverage. So far, 1.2 million fewer people signed up for Obamacare plans compared with last year, and health policy analysts estimate more will lose coverage as they fail to pay their premiums.
Health costs are a top concern for Americans. Two-thirds of the public say they are somewhat or very worried about affording health care, more than express the same worries about utilities, food, housing or gas, according to a January poll from KFF, a health information nonprofit that includes KFF Health News.
βAll of this pain just doesnβt have to be there,β said Cheryl Fish-Parcham, director of private coverage at the health consumer group Families USA.
Doctors and health policy researchers say health coverage of any kind is the best protection against major medical debt.
Caitlin Donovan, a senior director at the Patient Advocate Foundation, recommends exhausting every available option for health coverage before going uninsured.
Even a high-deductible plan can protect patients from medical bankruptcy βif the absolute worst-case scenario happens,β she said.
Here are five tips:
1. Talk with your doctor about money
Patients can be hesitant to tell their doctors theyβre uninsured or be wary of expressing concern about being able to afford care.
However, some hospitals, physicians, and other providers offer cheaper cash pay options, said Cynthia Cox, a senior vice president and the director of the Program on the ACA at KFF. Often prices are negotiable. βAlways ask,β she said.
Health care providers can make adjustments if they know patients are worried about money, said Ateev Mehrotra, a doctor and researcher at Brown University. A doctor, for instance, might order an ultrasound instead of an MRI, which is more expensive.
2. Search for providers that work with uninsured patients
Federally qualified health centers, or FQHCs, and other community clinics offer routine and non-emergency care, such as treatment for flu or infection, for low-income residents and the uninsured. These facilities charge based on a sliding scale and see 52 million patients annually in some of the countryβs most underserved areas, according to the National Association of Community Health Centers.
The Trump administration cut funding, which might lead some of the countryβs approximately 1,500 FQHCs to close or cut services, but maintains a site to find such centers.Β Most community clinics donβt offer specialty care, but usuallyΒ can refer patients who need more intensive services to providers willing to work with uninsured patients.
Planned Parenthood also accepts uninsured patients. Its centers test for sexually transmitted diseases, provide birth control options and offer postpartum and gender-affirming care and other services.
The National Association of Free & Charitable Clinics also offers a tool to help people find free or low-cost care.
Academic medical centers tend to have more charity care programs that help uninsured patients lower their bills.
Be wary of heading to the emergency room. While ERs are federally required to stabilize all patients regardless of their ability to pay, they can β and often do β leave you with a big bill.
3. Call your local health department
Health services vary widely from county to county, but many offer free vaccinations, family planning services and testing for sexually transmitted infections, as well as for flu, COVID-19 and tuberculosis.
Some county health departments also offer more advanced care, such as dental services and mental health or substance abuse programs. Some states have consumer assistance programs that can guide residents in finding care, Fish-Parcham said.
The Centers for Disease Control and Preventionβs National Breast and Cervical Cancer Early Detection Program makes free or low-cost breast and cervical cancer screenings available to low-income women in all states and territories. Some states cover screenings for other types of cancer as well.
4. Shop around for drugs
Donβt just fill your prescription at the closest pharmacy. Research generic drug options and look around for the best price on brand names.
A handful of sites such as GoodRx and WellRx offer comparison shopping tools and information on other ways to get drug discounts.
Some retailers also offer access to common prescription drugs at prices cheaper than through insurance. Walmart sells 90-day prescriptions of dozens of generic versions of drugs for $10, as does Target, Costco and a new site called the Cost Plus Drug Company.
Many drugmakers also offer patient assistance programs, coupons and rebates on some medications. Check their websites for details.
States also offer drug assistance programs. The steps to qualify and types of drugs vary; staterxplans.us has a list of programs and how they work.
Joining a clinical trial is another way to access treatment. The National Institutes of Health and its National Cancer Institute have lists, but patients must first meet the criteria. Clinical trials arenβt necessarily free, even with insurance, Donovan said, so be sure to ask about associated costs.
5. Diagnosis might lead to specialized resources
Patients with a specific diagnosis might have additional options for specialty treatment.
For example, someone with breast cancer should check with the American Cancer Society and the nonprofit Susan G. Komen organization, Cox said.
The Patient Advocate Foundation hosts a list of vetted foundations that can help offset the cost of medical bills and provide other resources such as transportation and lodging, Donovan said. Disease-specific foundations such as those for lupus or irritable bowel syndrome can also steer patients to free or low-cost resources or cover some costs of care.
Donβt be tricked by plans that look like health insurance but donβt offer guaranteed protection against big bills.
Read the fine print. Some red flags to look for: too-good-to-be-true monthly payments; no coverage for preexisting conditions; morality clauses such as those prohibiting the use of alcohol or drugs; or a lack of coverage for benefits such as mental health counseling that are required in ACA plans.
