Having that high-deductible health plan might kill you, literally

Having a high deductible health insurance plan can not only cost you dearly but it can also take your life.

A new study in JAMA Network Open found that people who faced higher out-of-pocket expenses along with a cancer diagnosis had worse overall survival and cancer-specific survival than people with more standard health plans.

The findings, though perhaps not surprising, are a stark reminder of the difficult decisions facing Americans as the price of health care continues to rise, and more people try to offset costs by accepting insurance plans with higher deductibles — that is, they have to pay more out-of-pocket costs before the health insurance provider starts paying their share.

This issue is especially acute right now for people who have insurance plans through the Affordable Care Act Marketplace. The prices of those plans have skyrocketed this year after Congress failed to extend a crucial tax credit. Without those credits, monthly premiums for ACA plans have more than doubled on average. Preliminary data on ACA enrollment for 2026 suggests not only that fewer people are signing up for plans, but also that those who are enrolling are more often choosing bronze plans, which are higher-deductible plans.

In the study, researchers considered plans “high-deductible health plans” (HDHPs) if their deductibles were at least $1,200 to $1,350 for individuals or $2,400 to $2,700 for families between 2011 and 2018 (with cutoffs rising within the range during that time). For context, according to KFF, the average individual deductible for an ACA Bronze plan in 2026 is about $7,500.

risky plans

Based on previous data, it is known that such high out-of-pocket costs lead people to delay or reduce health care—they may skip doctor visits, put off diagnosis, and avoid treatment. But for the new study, researchers led by Justin Barnes at the Mayo Clinic in Rochester, Minnesota, wanted to know more directly whether the plans were associated with shorter survival — especially for cancer patients, who clearly need more care than others.