After expired government subsidies increased out-of-pocket health care costs for many Americans, high deductible plans could now be putting the health of millions at risk.

According to a 2024 study, adults with diabetes who were forced to switch to a high-deductible plan could be facing dire health consequences: more than double the likelihood of blindness or developing end-stage kidney disease, an 11% higher risk of a heart attack, and a 15% higher risk of stroke, compared with other diabetic adults who had low-deductible insurance (1).

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David Garza is one of the many Americans who is struggling with this new reality. His new job includes an insurance plan with an annual deductible of $4,000, and as someone with Type 2 diabetes, the higher costs of treatment are forcing him to gamble with his health.

“I’m not on, technically, the right medication like before,” he shared with the Washington Post. “I’m having to take something that I can afford.” Garza has also stopped using a continuous glucose monitor to check his blood sugar levels, and his doctor visits have shown his levels are well above healthy targets.

“I’m just stuck, to be honest with you,” Garza added.

Unfortunately, plans with high deductibles are becoming the norm. In 2024, half of employers in the U.S. offered this type of insurance (2). In 2015, only 38% were offering the same. Those who use the Affordable Care Act marketplace plans are also facing high deductibles in some cases.

As more Americans face tough choices when it comes to paying for health care, many are being forced to make dangerous medical decisions based on financial cost rather than their needs.

The rising cost of health insurance

High-deductible plans can force diabetic patients to skip routine health maintenance, according to George Huntley, CEO of both the Diabetes Patient Advocacy Coalition as well as the Diabetes Leadership Council (1).

“You don’t take the drug that you’re supposed to take to maintain your blood glucose,” Huntley shared with the Post. “You ration your insulin, if that’s your scenario. You take pills every other day.”

Take Garza, for example. He’s chosen to only see his endocrinologist twice a year, despite the fact that he should be seeing this doctor four times a year. The appointments cost $150 per session, plus lab testing that costs $111 before each visit.

Yet in spite of the high costs for consumers, government spending on health care has also continued to rise astronomically in the U.S., especially in comparison to other G7 countries. According to analysis from KFF, government health spending tripled between 2000 and 2023, going from $1.4 trillion annually to $4.9 trillion in about two decades. In recent years, spending increased 7.5% between 2022 and 2023, and is projected to continue to rise (3).

Spending on health care in the U.S. outpaces other nations by a wide margin. As of 2023, U.S. spending on health care per person was at $13,432 annually, which is over $3,700 more than any other high-income nation (4). For example, spending in the U.K. was $6,023 per person for their universal health care program, $7,013 in Canada for the same, $7,136 in France and $5,640 in Japan.

In spite of this high government spending, U.S. citizens are burdened with high costs for health care as employers shift more of the insurance burden onto workers, all while households continue to struggle with inflation.

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Are you adequately insured?

Though 154 million Americans are covered by employer-sponsored health insurance plans (5), many people who may think they’re adequately insured could still be at serious risk if they have a high-deductible plan without enough personal savings to cover unexpected medical costs.

Since a 2024 GoBankingRates survey found that only 15% of men and 11% of women have more than $10,000 in savings, and half of the respondents reported less than $500 saved (6), that means many insured Americans could still be unprepared for medical emergencies.

Preparing for medical expenses

If you have a high-deductible plan, or your employer may be switching to this type of coverage, you should look into which preventive and chronic-care services are included in your coverage, and which are subject to the deductible. This can help you adequately plan for coverage that you may need, including common services like mental health care, physiotherapy, chiropractic or massage.

Rozalina McCoy, an associate professor of medicine at the University of Maryland School of Medicine, told the Post that these plans were meant to encourage people to become wiser health care shoppers (1). McCoy also said high-deductible plans can be a benefit to those who have savings, or who don’t require regular health care.

With this in mind, savvy shopping can include hunting for savings on lab visits, prescriptions and specialist visits by checking online platforms that help shoppers find better services in their area, and by negotiating prices with providers. You can also search for assistance programs in your state, as well as manufacturer discounts from pharmaceutical companies to potentially help you offset the cost of prescriptions.

To ensure you’re not skipping out on preventative and life-preserving treatments, talk to your doctor and come up with a plan together for your health care. You should also try to take advantage of an HSA if you can, or bump up the savings in your emergency fund.

Finally, you can speak to your company’s HR representatives for further information on the health plans available, and information on how coverage differs so you can make the right choice for yourself and your family.

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Article sources

We rely only on vetted sources and credible third-party reporting. For details, see our editorial ethics and guidelines.

The Washington Post (1); U.S. Bureau of Labor Statistics (2); KFF (3); Health System Tracker (4); Louisville Public Media (5); GoBankingRates (6).

This article provides information only and should not be construed as advice. It is provided without warranty of any kind.