Don’t Have Health Insurance? What’s the Worst That Could Happen? (2024)

Though the number of uninsured Americans has dropped, many people still don’t have any type of healthcare insurance coverage. The passage of the Affordable Care Act (ACA) allows millions to choose a government-subsidized healthcare plan. However, many consumers are ineligible for subsidies, and many of those who qualify have chosen not to participate.

In the first quarter of 2023, according to a preliminary report by the National Health Interview Survey (NHIS), 7.7% or 25.3 million adults (of all ages), lacked health insurance. Survey findings showed that the uninsured rate and number of uninsured decreased from Q4 2022 (8.3% or 27.3 million people of all ages).

Key Takeaways

  • Health insurance costs are on the rise for both employer-based and individual-based plans.
  • Americans are no longer taxed for not carrying health insurance.
  • Medical debt contributes to a large number of bankruptciesin America.
  • Access to quality primary care is critical, but doctors have the right to refuse patients withoutinsurance or who are able to pay out-of-pocket expenses.

As of 2019, individuals and families without insurance are no longer taxed due to the repeal of the tax-penalty portion of the Affordable Care Act.

Absence of Medical Services

Contrary to popular belief, health providers are not required by law to provide medical services to individuals without insurance. Only emergency departments are legally bound to provide care.

The National Center for Chronic Disease Prevention and Health Promotion reports that six in 10 Americans have been diagnosed with a chronic health condition, such as high blood pressure, high cholesterol, or being overweight or obese. A study by the Transamerica Institute revealed that 66% of the uninsured in 2019 suffered from a chronic illness. Ninety percent of the nation's $4.1 trillion in annual healthcare expenditures are from citizens coping with chronic diseases and mental health issues.

The ACA requires many preventive services to be covered by insurance policies with no copay, Transamerica’s executive director, Hector De La Torre, tells Investopedia. However, he says, “Not having health coverage can keep people from accessing free preventive care.”

Preventive care is crucial to spotting illness or conditions early before they can develop into full-blown critical problems, according to De La Torre. Catching health problems early increases the probability of successful treatment and also reduces healthcare costs for treatment.

Medical Debt

Without health insurance coverage, a serious accident or a health issue that results in emergency care and/or an expensive treatment plan can result in poor credit or even bankruptcy.

“A cancer diagnosis, car accident, or even a broken leg can cost thousands of dollars out of pocket," says Dylan Roby, the director of the Division of Health Policy and an associate professor of Health, Society, and Behavior at the UC Irvine Program in Public Health.

National surveys confirm that medical bills frequently cause financial hardship, and the Consumer Financial Protection Bureau reported that they were by far the most common cause of unpaid bills sent to collection agencies in 2014, accounting for more than half of all such debts. Even when medical debt doesn’t end in bankruptcy, it takes a toll on consumers.

According to a recent study in the Journal of the American Medical Association, 17.8% of individuals had medical debt in collections in June of 2020.

Consumers with massive medical debt are less likely to be able to save money and more susceptible to the type of financial strain that leads to forgoing necessities and borrowing money, according to the Kaiser Family Foundation.

No More Tax Penalties

In 2018, the ACA tax penalty was $695 for adults and $347.50 for children, or 2.5% of one's annual income, whichever amount was more. However, in 2017, when the Tax Cuts and Jobs Act was signed into law, it repealed the ACA-related tax on Americans who refuse to purchase health insurance.

As of 2019, Americans without health insurance are not taxed by the government. However, individuals and families who choose to go without health insurance do so at their own risk.

The Bottom Line

Healthcare is expensive—even with insurance. However, those who don’t have insurance coverage will be at a much greater disadvantage. The inability to seek treatment for health conditions and the crushing weight of medical bills are two big reasons to obtain coverage.

Don’t Have Health Insurance? What’s the Worst That Could Happen? (2024)


Don’t Have Health Insurance? What’s the Worst That Could Happen? ›

In a worst-case scenario, you could be sued and have your wages garnished. You might even be forced into bankruptcy. The Commonwealth Fund's 2023 Health Care Affordability Survey found that 38% of people surveyed said they delayed or skipped needed healthcare or prescription drugs because they couldn't afford it.

What are the risks of not having health insurance? ›

Without health insurance coverage, a serious accident or a health issue that results in emergency care and/or an expensive treatment plan can result in poor credit or even bankruptcy.

How can lack of health insurance make health worse? ›

Lack of health insurance coverage may negatively affect health. Uninsured adults are less likely to receive preventive services for chronic conditions such as diabetes, cancer, and cardiovascular disease.

What happens if you don't have insurance? ›

If you don't insure your vehicle you will get a Fixed Penalty Notice and if you still don't insure it, it could be seized, clamped or destroyed or you could be taken back to court.

What is the main reason people don't have health insurance? ›

uninsurance has been attributed to a number of factors, including rising health care costs, the economic downturn, an erosion of employer-based insurance, and public program cutbacks. Developing effective strategies for reducing uninsurance requires understanding why people lack insurance coverage.

How many Americans don't have health insurance? ›

The Share of Americans without Health Insurance in 2022 Matched a Record Low. In 2022, 26 million people — or 7.9 percent of the population – were uninsured, according to a report in September 2023 from the Census Bureau.

Should you always have health insurance? ›

Without insurance, these bills will add up fast, they'll be devastating and they will cost too much. No matter what type of insurance you have, your plan is required to help you pay for 10 important health services. They are called Essential Health Benefits.

Can the US afford free healthcare? ›

If you look at the numbers, there simply isn't enough spare money in the budget to be able to afford to put every citizen on a Medicare/Medicaid program. However, if a deeper look is taken into other programs and tax breaks, affordability is possible.

What percent of Americans can't afford healthcare? ›

About half of U.S. adults say it is difficult to afford health care costs, and one in four say they or a family member in their household had problems paying for health care in the past 12 months.

What is the best most affordable health insurance? ›

Best Affordable Health Insurance Companies
  • Kaiser Permanente – Cheapest Health Insurance Company.
  • Blue Cross Blue Shield – Best Provider Network.
  • UnitedHealthcare – Best for Customer Satisfaction.
Apr 15, 2024

Why is insurance so expensive? ›

But rising car repair costs and an increase in disaster-related claims are significant reasons why car insurance rates are surging for many drivers.

What is the uninsured driver promise? ›

If an uninsured driver hits you and it's not your fault, you shouldn't be penalised. So, if that ever happens, you won't lose your No Claim Discount with us and we'll cover your excess.

What is 3rd party insurance? ›

Key Takeaways. Third-party insurance covers an individual or firm against a loss caused by some third party, such as car insurance. The first party is the insured, the second party is the insurer, and the third party is the person causing the loss or claim.

What age group is the most uninsured? ›

In 2019, adults aged 18–44 were the most likely to be uninsured (17.0%), compared with adults aged 45–64 (11.1%) and children under age 18 years (5.1%).

How much is health insurance in America per month? ›

The average monthly health insurance cost for a bronze plan is $373 for a single 30-year-old person. That same person pays an average of $488 for a Silver plan and $634 for a Gold plan. A 40-year-old single person pays $420 on average each month for a bronze plan, $549 for a silver plan and $713 for a gold plan.

Are public hospitals free in the USA? ›

The U.S. government does not provide health benefits to citizens or visitors. Any time you get medical care, someone has to pay for it. Healthcare is very expensive. According to a U.S. government website, if you break your leg, you could end up with a bill for $7,500.

What are the pros and cons of not having health insurance? ›

The pros of not having health insurance include avoiding premium costs, increased choice in healthcare providers, and potential tax benefits. However, the cons consist of high out-of-pocket expenses, limited access to care, and a lack of financial protection against catastrophic events.

Why is it important to have insurance? ›

Insurance can add predictability and security to your financial plan. Another benefit of insurance is that it can add some predictability to your legacy and estate plan. Investments, real estate, business interests and other investment assets can vary in value over time.

What are some problems with health insurance? ›

About half (48%) of insured adults worry about affording their monthly health insurance premium and large shares of adults with employer-sponsored insurance (ESI) and those with Marketplace coverage rate their insurance as “fair” or “poor” when it comes to their monthly premium and to out-of-pocket costs to see a ...

What can insurance protect you from? ›

An insurance policy can protect you from the hazards of normal life, from floods and fires to car accidents and life-threatening illnesses.


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