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

Having a health insurance plan with a high deductible could not only cost you—it could also kill you.

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

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

The issue is particularly critical right now for people who have insurance plans through the Affordable Care Act marketplace. Prices for those plans have skyrocketed this year after Congress failed to extend critical tax credits. Without those credits, monthly premiums for ACA plans have, on average, more than doubled. Early data on ACA enrollments for 2026 not only suggests that fewer people are signing up for the plans, but also that those who are enrolling are often choosing bronze plans, which are high-deductible plans.

In the study, researchers considered plans to be “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 the cutoffs increasing within the ranges during that time). For context, the average individual deductible for an ACA bronze plan in 2026 is about $7,500, according to KFF.

Risky plans

Based on previous data, such high out-of-pocket costs are known to lead people to delay or decrease health care—they may skip doctor visits, put off diagnostics, and avoid treatments. But for the new study, researchers led by Justin Barnes at Mayo Clinic in Rochester, Minnesota, wanted to know, more directly, if the plans were linked to lower survival— specifically for cancer patients, who obviously need more care than others.