High-deductible health plans push millions into financial ruin and skipped care

High-deductible health plans (HDHPs) now cover nearly half of Americans under 65. These plans often leave families struggling with steep out-of-pocket costs. New research shows the financial strain can lead to skipped treatments, mounting debt, and even early death. In 2023, the average HDHP deductible reached $2,418 for individuals and $4,674 for families. Yet around 50% of American households cannot afford these costs. Many enrollees face tough choices: delaying doctor visits, cutting medication doses, or avoiding prescriptions entirely.

A four-year study found that 26% of HDHP enrollees experienced financial hardship or skipped care, compared to just 11% over a single year. Even short gaps in coverage raised the risk of money troubles. Worse still, over half of the patients who died during the study had faced healthcare-related financial stress. With 42% to 58% of under-65 Americans now on HDHPs, the consequences are widespread. Unexpected medical bills—even a $400 expense—can push nearly 40% of households into crisis. For some, the strain leads to bankruptcy, worsening health, or premature death.

The rise of HDHPs has tied higher costs to basic healthcare decisions. Patients skip treatments, take on debt, or face financial ruin when illness strikes. Without changes, the trend could deepen health and economic struggles for millions.