A $250K heart attack: Cheap health plans are sticking Americans with six-figure medical bills, and their popularity may grow as ACA premiums skyrocket

ACA enhanced premium tax credits introduced in 2021 and later extended through the end of 2025 by the Inflation Reduction Act are set to expire at the end of this year. With millions facing massive premium increases, they may be tempted by cheap plans, unaware they're buying what the Biden administration labeled "junk insurance.”

Rising premiums means millions of uninsured Americans

The expiration of enhanced tax credits will devastate household budgets. Even those not reliant on these subsidies will be affected. Since the healthy and young will likely drop coverage, insurers will have to bump up premium prices as their risk pool changes.

According to KFF analysis, out-of-pocket premiums would rise by over 75% on average for the vast majority of individuals and families buying coverage through the ACA Marketplace (2). Currently subsidized enrollees will see their monthly premium payments more than double, increasing by about 114%, on average (3).

Yet Trump and Congressional Republicans refuse to extend these subsidies. The result, the Congressional Budget Office projects, is 2.2 million people losing coverage in 2026, rising up to 3.8 million annually through 2034 (4).

The dangerous appeal — and hidden risk — of cheap plans

Short-term plans can cost half as much as ACA coverage. A 40-year-old Florida nonsmoker might pay $500 monthly for the cheapest ACA plan versus $320 for short-term coverage, according to Washington Post reporting. It further explains that the Trump administration expanded the duration of these plans in 2018, allowing policies to last up to three years instead of four months. In a statement to The Washington Post, the Centers for Medicare and Medicaid Services said they can play "a crucial role in offering stopgap coverage solutions … and can be significantly cheaper than ACA coverage."

While this sounds appealing, the savings evaporate catastrophically when serious illness strikes. Unlike ACA plans, short-term coverage isn't required to include prescription drugs, mental health services, maternity care or protections for pre-existing conditions, according to KFF research (5). It further notes almost half don't cover outpatient prescriptions and 40% exclude mental health services — benefits that ACA plans must provide.

Five states have banned short-term plans outright, says KFF. Nine more impose rules so restrictive that no insurers offer them. Even large insurers questioned the wisdom when Trump first expanded access. Cigna executives warned consumers would "find themselves in need of certain benefits or protections," the Post reports, while Aetna recommended including more consumer safeguards.

And it's insurance agents who see the wreckage firsthand. "I've seen consumers get hit with $250K bills after a heart attack or a $375k bill for a 6-week hospital stay," wrote a Reddit user who identified themselves as a “national health agent” (6). This certainly sounds plausible. Earlier this year, a Canadian woman who suffered a cardiac arrest in Florida told CTV News she was on the hook for $290,000 because her claim was denied (7).

What you need to know

If you fear your health insurance costs are about to skyrocket, there are some things that can ease the long-term burden. Following these tips can help you avoid staggering health care bills, in the event you're ever in a catastrophic situation.