While Congress continues to debate Affordable Care Act (ACA) subsidy extensions, time is running short as the Jan. 15, 2026, deadline draws near, and as millions of Americans risk having to pay soaring prices for health insurance next year.
That’s a big deal, as average monthly premiums after advanced payments of the premium tax credit stand at around $113 per month, while the average ACA policy costs without these subsidies would average around $619 monthly, according to the Centers for Medicaid & Medicare Services.
More than 24 million people enrolled or were re-enrolled in ACA coverage during this year's open enrollment period, which ran from Nov. 1, 2024, through Jan. 15, 2025, according to the Centers for Medicaid & Medicare Services. And during this time, 42 percent of consumers selected a plan for $10 or less per month after advanced tax credits.
The pending loss of subsidies may force U.S. healthcare consumers to look elsewhere for coverage, with so-called alternative healthcare plans high on the list.
Alternate healthcare plans are non-ACA-compliant health coverage options not available through an ACA marketplace. They’re often cheaper and more flexible, but they don’t provide the same consumer protections or guaranteed benefits as ACA plans.
With ACA subsidies unresolved, alternative health care plans are getting a closer look from U.S. households right now.
“Alternate medical plan enrollment is on the rise,” according to Alight Solutions, a Chicago-based cloud-based employee benefits services provider, said in a new report. “Across most salary ranges, 2026 alternate medical plan enrollment doubled from 2025, growing fastest among lower-income workers.”
Plan Design Features Vary
According to Alight Solutions, alternate plans can be based on different factors: “Plan design features such as copays instead of a high deductible, reference-based pricing, primary care-centered approaches, and value-based care often provide employees with more predictability with out-of-pocket costs, even if pricing is around the same or higher than traditional plans.”Potential Lower Costs and Simplicity
Many alternative plans have lower monthly expenses and can work well for routine care, especially for healthy, financially prepared people. “Some models, like Direct Primary Care, can actually improve access and the patient experience,” Henry Criss, chief executive officer at Fraum Health in Hilton Head, S.C., told NTD News.Risk May Be Higher
Some alternate healthcare plans are not regulated like insurance. They may not cover major medical events, may exclude certain conditions, or may not guarantee that claims will be paid.They Can Deliver Some Peace of Mind
One positive takeaway is that alternative plans can provide consumers with peace of mind, allowing them to allocate funds to their monthly household budget.“You get to avoid the high-deductible gambling game that leaves so many families vulnerable to a financial calamity if an unexpected accident occurs,” Rami Sneineh, vice president at Insurance Navy, a privately owned insurance brokerage firm, told NTD. “When you’re trying to save up for a home or pay off debt, you need a stable burn rate and not a budget that swings wildly depending on a medical emergency.”
Are Alternative Healthcare Plans Right For You?
Criss’s take is that alternative healthcare plans are neither inherently good nor bad, as it all depends on a consumer’s unique needs.“Alt healthcare plans can make sense in the right situation,” he said. “The real problem is when people assume they are a full replacement for comprehensive insurance without understanding the trade-offs. In many cases, the smartest approach is a combination that protects against major risk while using more flexible models for everyday care.”