Courtesy of Kris Ann Valdez
When my husband was unemployed, we qualified for government health insurance. For the first time in my adult life, I didn’t worry about meeting deductibles for broken bones, surgeries, or other emergencies. The plan covered everything. I felt an invisible weight lift off my shoulders.
As Murphy’s Law would have it, I only used this plan a few times for primary care visits and to get my children’s dental cleanings. But two days after ending the plan and joining a healthshare, my daughter broke her collarbone.
Healthshares are community-based, where members contribute to a communal bucket and then share medical costs.
We paid out of pocket for the X-rays and urgent care visits until we met the $1,000 per incident requirement, as outlined in our new healthshare plan. Thankfully, we were reimbursed for $1,000 in physical therapy within a few weeks of submitting the claim.
Because healthshares aren’t legally bound like health insurance companies, I decided to reconsider and look into traditional healthcare for my family for 2026.
I started searching for a new plan
I visited healthcare.gov this month to preview the marketplace ahead of open enrollment on November 1.
After entering my family’s information (married, three dependents) and our income, the site populated three tiers: bronze, silver, and gold, with premiums ranging from $271 to $677 a month.
At first glance, it all looked promising.
I hovered over a Silver Elite Saver Plus HMO plan, priced at $590.32 a month. It offered a $0 family deductible (except for a $400 drug deductible) and a $18,200 family out-of-pocket maximum. Primary care visits were $60, specialists’ visits were $100, and ER visits were covered at 50%.
Another zero-deductible plan capped out-of-pocket expenses at $11,000, but cost around $942 monthly, which felt out of reach for my budget.
The cheapest plans covered the bare minimum with sky-high deductibles ($15,000 family deductible; $18,400 out-of-pocket max) for about $271 a month.
The Silver HMO plan seemed like the best fit for our young, healthy family — until I took a closer look.
I didn’t understand how the tax credit worked at first
Under every plan’s bold pricing, I noticed the fine print, including an estimated $905 a month tax credit.
I called Obamacare-Registration, a private company with no affiliation with the government, to speak with a representative for clarification. They said these are “the subsidies, what the government gives you to help you pay for your premium.”
The plans rely on this tax credit — different than your annual tax return — to lower premiums for qualifying households.
But if your income rises midyear, you could owe part of that money back at tax time. As a freelancer, I am nervous about using a subsidy because my income fluctuates and I don’t want to get stuck with a repayment bill.
Additionally, unless Congress extends the subsidies set to expire at the end of the year, that plan could cost us more.
In our case, if the subsidy goes away, every plan costs $905 more a month. The silver plan I liked? It would cost us $1,495 a month.
We’re likely staying with the riskier healthshare
We pay $518 a month for our Zion HealthShare — although we just received an email stating that prices will increase in 2026. We pay $1,000 per eligible incident, and that price will rise to $1,250 in 2026.
It’s unsettling to know reimbursement isn’t guaranteed, but it’s also nearly $1,000 a month cheaper than comparable insurance. Coverage kicks in at $1,250 per incident, versus meeting much higher deductibles with many traditional plans. That’s a major difference for families like mine, and so far, our healthshare has honored its commitments to us.
If the subsidy disappears, my family would be left paying a mortgage-sized premium. So we are more than likely sticking with our healthshare.
Editor’s Note: A representative from Zion HealthShare told Business Insider, “As medical costs continue to rise nationwide, small adjustments are sometimes needed to maintain the long-term strength of the community. Even with these adjustments, Zion HealthShare remains the most affordable option for managing medical expenses, while still providing a reliable, community-based alternative to traditional health insurance.”
A Centers for Medicare & Medicaid spokesperson told Business Insider, “Ensuring access to affordable healthcare remains a critical and unwavering priority for CMS. Final 2026 rates are set by issuers and reviewed by state regulators or CMS. Eligible HealthCare.gov enrollees continue to have robust access to low-premium plans after applying advance payments of the premium tax credit. In plan year 2026, most enrollees on Healthcare.gov will have access to plans with premiums at or below $50 per month, after the application of premium tax credits. The Premium Tax Credit is a refundable tax credit, and the amount is determined separately from other amounts of refund or tax due.”
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