healthsherpa

First off, here's a resource that may be useful: https://www.healthsherpa.com/blog/free-or-low-cost-medical-care/

With respect to other options, IMHO there are no other options that are worth your money. People will try to sell you a lot of things (e.g. short term insurance, hospital indemnity, health care sharing ministries, critical illness aka "cash cancer", etc) but all of that is inadequate coverage designed to make the insurer / broker money that doesn't cover you when you need it most. The two most popular you may hear about are short term and Christian Health Care Sharing Ministries, so here's some more detail on that.

Big disclaimer: We are biased here because we only sell what we consider to be real health insurance - ACA plans that have to cover pre-existing conditions, hospitalization, prescription, doctor visits, etc. We're also biased because when people have bad experiences with this other stuff we end up having to try to clean up the mess and get them real coverage.

SHORT TERM

Short term doesn't cover prescriptions, pre-existing conditions, or pregnancy/maternity. They do something called, “underwriting at the time of claim” where they wait until you try to use the insurance to find a reason to deny you. Like when you're sitting in the hospital. California has banned them completely. Probably better than nothing if you can’t afford real health insurance, but caveat emptor. Some insurance agents love them and will recommend them because they pay 25-30% commissions (vs ~2% for ACA plans, if they pay commissions at all).

CHRISTIAN HEALTH CARE SHARING MINISTRIES

Christian health care sharing ministries are big business masquerading as religion. They are basically unregulated - aren’t required to cover everything, aren’t audited to make sure they have enough money to pay claims, and there are a LOT of loopholes that can result in coverage being denied. Here’s an example from the actual T&C of one of these organizations:

F. Pregnancies of Unwed Mothers

Members agree that sex should be exclusively within Biblical Christian Marriage. Thus, maternity medical expenses for newborns conceived outside of marriage are ineligible for sharing.

That's just an example, God forbid you get sick doing something immoral, they can basically deny your claim at their discretion. Interestingly, also pay 25-30% commissions to the broker.

Under the ACA, insurers have to cover pre-existing conditions. If you could sign up any time during the year, people would just wait until they get sick to buy health insurance, which would wipe out the insurance companies. That's the logic behind open enrollment/those dates.

We show all the same plans, at the same prices, and don’t bias our sorting or recommendations in any way. We focus on providing better customer service, and expert assistance year round if you have questions, need to make changes, or would like help using your coverage. So you get everything you get on Healthcare.gov, plus these people ready to help: https://www.youtube.com/watch?v=xB7HrDusl8E (that's our actual team, not paid actors). Basically whenever you need help, we're here for you.

That is a very complicated question, and one we're not particularly qualified to answer. At a high level, there are a number of factors - here's a partial list in no particular order:

- defensive medicine

- lack of rationing

- lots of choice/options

- pharmaceutical prices

- malpractice lawsuits

- most people don't pay for healthcare directly

- complex, convoluted, broken billing system

- massive waste in the system

- the American diet

- private companies wanting to make profit

- US doctors get paid a lot relative to other countries

The list goes on and on. Much of the debate about why US healthcare is so expensive is centered around what should be on this list, and how much each item on this list matters relative to the others. This is one of the biggest problems this country faces right now - nearly $1 of every $5 of GDP goes to health care and that share is growing faster than the economy. Sorry we can't provide a better answer.

You are probably seeing higher copays and deductibles which has definitely happened. By "covers more" I mean covers ALL pre-existing conditions, no lifetime limits on payouts (used to be a huge problem for NICU babies who would cost $1-$2m at birth and basically be capped out for life with that insurer), has to cover medically necessary prescriptions, has to provide free preventative care, etc etc.

To your point about young people though - the ACA capped the ratio of how much a 64 yr old pays to what a 21 yr old pays at 3 to 1 (so 64 yr old can pay max 3x what a 21 yr old does). Pre ACA that ratio was anywhere from 5 to 1 to 11 to 1, so its true that young people are being asked to pay disproportionately more to cover old people than they used to.