July 24, 2025 – Health insurance is in the spotlight these days, especially the risk of losing it.
The recently passed federal budget bill that includes significant Medicaid cuts is projected to leave millions uninsured over the next decade. An additional 4.2 million Affordable Care Act enrollees may be priced out, as premiums are expected to rise sharply for next year.
But here's what you may not have heard: Tens of millions of Americans – about 7.6% of the population, according to the most recent data – already lack insurance, whether they've lost their job, can't afford a health plan, or have trouble signing up.
Losing insurance doesn't just pose a financial burden – research shows it can directly harm your health. Fortunately, there's a lot you can do right now to protect both your health and your coverage.
How Losing Insurance Hurts Your Health
"When people don't have insurance, they stop seeking regular health care," said Joel Shalowitz, MD, a retired professor at Northwestern University's Kellogg School of Management.
That's not just speculation. Research shows that when coverage disappears, people struggle to afford care and skip health services and medications. The upshot: fewer checkups, missed vaccinations, and gaps in treatment for chronic conditions like high blood pressure and diabetes – issues that can become serious problems if left unchecked.
"Chronically ill individuals are going to be more at risk from health care cuts," said Adam Gaffney, MD, a public health expert at Harvard Medical School.
But even the healthy face risks if they fall behind on preventive care.
A study from the American Cancer Society found that disruptions in coverage led to fewer preventive services and screenings among participants. The findings for cancer patients were stark: Those with gaps in Medicaid coverage were more likely to have advanced stages of disease and die earlier, compared with those who remained covered – demonstrating the life-or-death consequences of coverage loss.
New mothers can face serious outcomes too: In a 2024 study, those who lost insurance were 19% less likely to attend postpartum visits and 14% less likely to be screened for postpartum depression – an oversight with serious mental health impacts for both mothers and their children, as a wide body of research shows.
How to Protect Your Health and Your Coverage
If you have coverage now, don't put off preventive care, said Shalowitz. Stay up to date on mammograms, colonoscopies, Pap smears, and other routine screenings. Likewise, schedule appointments you've been putting off, and refill your prescriptions.
That will help head off the possibility of health problems during an uninsured period – but keep in mind, it's no guarantee.
"At the end of the day, health is ultimately unpredictable," Gaffney said. "None of us know when the next problem is coming down the pike at us, and that's why we need lifelong, seamless coverage, because health problems are something everyone will ultimately face."
Consider these steps:
If you're on Medicaid …
What to do: Stay in touch with your state Medicaid agency.
"The biggest provision that's going to impact people with Medicaid is the [introduction of] work requirements," said Gaffney. By 2027, many on Medicaid will need to prove they've completed 80 hours of work or community service per month, or that they've attended school.
Some will lose coverage if they don't comply. "But it will very likely sweep in many, many people who are in compliance but struggle to meet the administrative burden to prove they're in compliance," said Elizabeth Kaplan, JD, director of health care access at Harvard Law's Center for Health Law and Policy Innovation.
"Individuals with Medicaid are going to have to be really careful not to miss any communications from their states," she said. So make sure your state Medicaid agency (and Medicaid managed care organization, if you have one) has your up-to-date contact information. Respond promptly to notices regarding actions to maintain your insurance.
What documents might your state require? We may not know for sure for another year. In Georgia, which already has similar requirements, beneficiaries are asked to submit work pay stubs or signed letters on official letterhead from organizations where they volunteer.
If you're on Medicare …
What to do: Follow the news, stay informed, and check your Part D plan costs during annual enrollment.
The new bill didn't introduce major cuts to Medicare, but recipients may still see indirect impacts in the coming years. That's because the new law raises the deficit, triggering sequestration rules, or automatic spending cuts, said Gaffney. That could lead to $500 billion in Medicare cuts over the next decade, unless Congress acts to stop it.
If you're on Medicare and Medicaid, you may be affected sooner. While the new Medicaid work requirements may not apply to you, the law's other Medicaid provisions could – like cuts to state funding or new cost-sharing for services. Because Medicaid helps offset out-of-pocket costs for many on Medicare, losing it could render care and prescription drugs unaffordable, he said.
One thing you can do is maximize your Medicare coverage without overpaying. Shalowitz recommends reviewing prescription coverage (Medicare Part D) options annually, even if you auto-renew. The reason: Your health status and medications can change, so the plan you had last year might not be the most cost-effective option now. Plus, "a lot of plans will give a lower rate one year to get you to sign up, and then they'll increase it dramatically the next year," he said. Simply taking the time to compare plans on medicare.gov could save you hundreds of dollars a year.
If you buy insurance through the ACA marketplace …
What to do: Anticipate higher premiums and start saving.
The new bill didn't extend subsidies that lower the price of marketplace plans. "The majority of people with ACA plans get subsidies, meaning the premium is lower than it would be if they were just paying the market price," said Gaffney.
Premiums will likely rise in January. And eligibility requirements are getting stricter, too. During open enrollment, pay close attention to both the costs and the documents required to enroll as soon as the information is available. It might help to have a copy of your latest tax return handy, for example. Enrollees will be asked to verify their household and family size, immigration status, health coverage, and place of residence.
If you have employer-based coverage …
What to do: Pay attention to changes in your local hospitals and clinics – and speak up if you're concerned.
"All of us may be worse off if these Medicaid cuts lead to hospital closures or limits on access to care for everybody," said Sherry Glied, PhD, a public service expert at New York University. Emergency departments, especially in low-income areas, might have to treat more uninsured patients for free, which will hurt their bottom line.
"People have talked about rural hospitals, but it's not just rural hospitals – it's urban, suburban, and rural hospitals that predominantly take care of working-class people," said Gaffney. These facilities are "more reliant on Medicaid revenues in order to stay afloat."
When Medicaid revenues go down, uncompensated care costs from uninsured patients go up, he said. Hospitals then face the choice of cutting staff or services or even closing altogether.
The downstream effects could hit your paycheck in 2027 and beyond. To offset the free care they provide, hospitals will probably charge private insurers higher rates for services, said Shalowitz. That could mean higher premiums for employers – which in turn could mean higher premiums for you if your employer asks you to kick in more each month to cover the cost.
Your moves: Stay informed, use preventive care, and reach out to elected officials if you're concerned. Your voice can help shape how these changes unfold, the experts agreed.
If you don't have insurance …
What to do: Take advantage of free clinics.
These facilities, which are often funded through government grants, funds from community and private foundations, or donor support, provide care for people who are uninsured or underinsured. Check the National Association of Free and Charitable Clinics' searchable directory of clinics across the country and the Health Resources and Services Administration's list of its funded health centers.
Also check discount programs, like GoodRX, to save money on medications, said Shalowitz. And ask your doctor about cheaper alternatives to your current medications.
