What Happens if You Don’t Have Health Insurance?
Lacking health insurance exposes you to hefty medical bills and high out-of-pocket expenses. It also limits access to preventive care and essential treatments, but you can avoid these situations by buying a health plan.
MF
By Mark Fitzpatrick
MF
Head of Insurance, MoneyGeek
Mark Fitzpatrick is a Licensed Property and Casualty Insurance Producer and MoneyGeek's Head of Insurance. He has analyzed the insurance market for over five years, conducting original research and creating personalized content for every kind of buyer. He has been quoted in several insurance-related publications, including [CNBC](https://www.cnbc.com/2020/04/15/cant-keep-up-with-insurance-premiums-heres-what-to-do.html), [NBC News](https://www.nbcnews.com/business/autos/flooded-cars-are-problem-their-owners-future-car-buyers-n1278493) and [Mashable](https://mashable.com/article/tesla-insurance-rates). Fitzpatrick earned a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He is passionate about using his knowledge of economics and insurance to bring transparency around financial topics and help others feel confident in their money moves.
Edited by Casie McCoskeyCasie McCoskey is a professional editor passionate about providing people with accessible information on personal finance. Before MoneyGeek, she worked in the legal field, drafting and editing briefs and motions.
MF
By Mark Fitzpatrick
MF
Head of Insurance, MoneyGeek
Mark Fitzpatrick is a Licensed Property and Casualty Insurance Producer and MoneyGeek's Head of Insurance. He has analyzed the insurance market for over five years, conducting original research and creating personalized content for every kind of buyer. He has been quoted in several insurance-related publications, including [CNBC](https://www.cnbc.com/2020/04/15/cant-keep-up-with-insurance-premiums-heres-what-to-do.html), [NBC News](https://www.nbcnews.com/business/autos/flooded-cars-are-problem-their-owners-future-car-buyers-n1278493) and [Mashable](https://mashable.com/article/tesla-insurance-rates). Fitzpatrick earned a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He is passionate about using his knowledge of economics and insurance to bring transparency around financial topics and help others feel confident in their money moves.
Edited by Casie McCoskeyCasie McCoskey is a professional editor passionate about providing people with accessible information on personal finance. Before MoneyGeek, she worked in the legal field, drafting and editing briefs and motions.
Updated: May 22, 2024
Advertising & Editorial Disclosure
Without health insurance, people face potential financial strain and limited access to health care services. While there's currently no federal tax penalty for being uninsured, the risks are significant. Medical expenses, from routine doctor visits to emergency room trips, can incur substantial out-of-pocket costs.
Unfortunately, most people who do not have health insurance are missing out on coverage due to factors like the high cost of premiums and changes in existing employment.
Health insurance is a secure and safe choice, especially if you have a chronic illness or frequently require medical services.
Why Do People Go Uninsured?
According to KFF's analysis, the main reasons non-elderly adults between ages 18 and 64 don't have health insurance are:
Coverage not affordable: 70%
Not eligible for coverage: 26%
Do not need or want: 24%
Signing up was too difficult or confusing: 20%
Cannot find a plan that meets needs: 18%
Lost job: 4%
Kaiser Family Foundation (KFF) analysis of the 2022 National Health Interview Survey
If you don’t have health insurance, you might bear the entire financial burden if you get sick or suffer from an injury. You also may not be able to receive care at a hospital, except in case of emergencies. Preventive care and early disease detection may be neglected without coverage, impacting your long-term health. Generally, in the case of chronic illnesses, medical expenses often add up quickly, potentially leading to substantial debt.
You may not receive medical care if you go to a hospital without insurance. Hospitals don't need to provide non-emergency care to the uninsured since there is no legal requirement to do so. Without health care coverage, hospital visits, diagnostic tests and treatments for chronic diseases like heart disease, cancer or diabetes can lead to high out-of-pocket costs. Chronic diseases are the major contributors to the nation's $4.1 trillion annual health care costs.
Negotiating lower fees becomes challenging, and access to discounts is limited. Moreover, hospitals often charge uninsured patients significantly more than health insurers, potentially leading to financial ruin. While some hospitals offer financial assistance programs, it's beneficial to inquire about these options beforehand.
Note that the Affordable Care Act (ACA) mandates insurance coverage for many preventive services with no copay, providing a valuable benefit for individuals who obtain health insurance.
Access to preventative drugs and medications becomes limited for the uninsured due to the rising prescription drug prices, which stand at around $1,050 per person, as per National Health Expenditures Accounts (NHEA).
Going without insurance coverage affects the management of acute and chronic medical issues. Without a health insurance plan, individuals may forgo essential medications for acute and chronic conditions, worsening health and increasing long-term medical costs.
Uninsured, non-elderly adults, as highlighted by the Kaiser Family Foundation (KFF), are two-and-a-half times as likely to delay or skip needed drugs due to cost constraints.
Being uninsured can lead to substantial medical debt, potentially causing financial hardship and even bankruptcy. And if you are someone with a chronic illness or any other health issue, medical debt might accumulate over time. A KFF and Peterson Centre for Healthcare analysis reports that nearly one in ten adults in the U.S. have medical debt.
Health care debt hits hard. Six in ten adults with health care debt have cut back on essential spending, such as food and clothing. Nearly half have depleted their savings, and about four in ten increased credit card debt or took on extra jobs to cope. Bills often get delayed, and people put off significant life plans to make ends meet.
Congress eliminated the federal tax penalty for not having health insurance effective January 1, 2019. Consequently, there is no longer a federal requirement for health insurance. The Affordable Care Act initially mandated this through the individual mandate.
However, it's important to note that some states have implemented a version of the individual mandate, maintaining health insurance coverage requirements. It is mandatory to have health insurance in these states.
States With Tax Penalties
States and localities that maintain individual health insurance mandates with state tax penalties include the following:
Vermont has an individual mandate but has yet to impose a tax penalty.
It is generally not recommended to go without health insurance as you are always at risk of facing sudden and severe health challenges, whether due to unexpected illnesses or accidents. In such situations, the absence of health coverage means that every health care cost must be personally covered, leaving individuals vulnerable to substantial financial strain.
While it's not a legal requirement to have health insurance in most states, buying a health coverage plan is a wise decision because of its many benefits.
Health insurance protects against high out-of-pocket costs, preventing potential financial strain during unexpected health crises.
Access to Preventive Care
Health plans often cover preventive services, facilitating early detection and proactive management of health conditions.
Network of Providers
Health insurance plans typically come with a network of health care providers, ensuring access to a range of medical services.
Knowing you have health coverage brings peace of mind, allowing you to focus on your health without worrying about potential financial strain.
Affordable insurance plan options are available through employer-sponsored plans or subsidized plans on the Affordable Care Act (ACA) marketplace. Even if one doesn't qualify for subsidies, opting for a lower-cost plan, such as a Bronze plan on the marketplace or a high-deductible health plan from an employer, is prudent.
Opting not to have health insurance may seem cost-effective initially, but the potential financial risks far outweigh the short-term savings. High out-of-pocket expenses, escalating prescription costs and the impact of inflation can quickly outweigh any perceived savings. Unanticipated medical events can lead to substantial financial strain, making health coverage a wise investment for long-term financial security and peace of mind.
Can I go to the emergency room without insurance?Yes, you can go to the emergency room without insurance. Emergency rooms are obligated to provide care regardless of insurance status. However, you'll be responsible for the total cost of services. Having affordable insurance options or participating in any financial assistance programs beforehand is advisable for comprehensive coverage and financial protection in emergencies.
About Mark Fitzpatrick
Mark Fitzpatrick is a Licensed Property and Casualty Insurance Producer and MoneyGeek's Head of Insurance. He has analyzed the insurance market for over five years, conducting original research and creating personalized content for every kind of buyer. He has been quoted in several insurance-related publications, including CNBC, NBC News and Mashable.
Fitzpatrick earned a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He is passionate about using his knowledge of economics and insurance to bring transparency around financial topics and help others feel confident in their money moves.
