Why Health Insurance Is Out of Reach for Many Young Adults, and What You Can Do

The Struggle for Health Insurance

When Boulder, Colorado resident Delaney Harris began her graduate studies at the University of Denver in February 2025, she found herself without health insurance. 

Given that she was 26 years old, she could no longer piggyback on her parents’ health plan—and some fine print regarding remote classwork stymied her attempts to get coverage through the university. 

Initially undeterred, Harris tried applying for Health First Colorado, the state’s Medicaid program, only to find herself in a lengthy holding pattern. She also explored private insurance, but found that policies were prohibitively expensive.  

“My income was so low,” she said. “I’m already taking student loans. There was no way I was going to be able to pay $200 to $300 a month for private insurance.”

So Harris made the tough choice to go without health insurance—and has been without it for the last six months, skipping doctor appointments, delaying preventive care, and relying on pricey urgent care facilities for emergencies. 

“It was frustrating,” Harris said. “I got really sick in March, and I needed antibiotics. It was such an ordeal to not have insurance … I didn’t even end up getting a prescription.”

Harris’s time without health insurance will end in a few weeks when her current internship turns into a full-time job, and she’ll, somewhat unexpectedly, qualify for employer-sponsored benefits. (“It’s a miracle,” she said.) But her struggle story isn’t an isolated one in today’s market. 

Why Young Adults Are Falling Into a Coverage Gap

Before looking at why young adults are struggling today, let’s revisit past coverage trends. Key provisions of 2010’s Affordable Care Act (ACA) went a long way toward decreasing the uninsured rate among young Americans. Most notably, the law mandated that private health plans offering dependent coverage allow children to stay on a parent’s plan until they turn 26, as opposed to 19, the prior traditional cutoff for non-full-time students. 

The ACA also allowed states to expand Medicaid, the public health insurance program for low-income Americans, to nearly all adults with incomes up to 138% of the federal poverty level (FPL).

But these stipulations don’t fully protect people over 25 who have yet to find a job offering health benefits. They also don’t shield young adults from a decade-and-a-half’s worth of GOP-led policy rollbacks, like the removal of the individual mandate, the 10 state governments that refused the optional Medicaid expansion, and the government allowing increased access to shoddy, short-term health plans. The ACA provisions also don’t protect against cumulative price increases. 

“Once young adults turn 26 and they fall off their parents’ insurance, there’s a major affordability and accessibility issue,” said Krystal Milam, national policy and advocacy director at Young Invincibles, a youth advocacy group. 

A Widening Chasm

According to Census Bureau data, 12.6% of Americans aged 24 to 34 were still uninsured as of 2023—a statistic that is likely to worsen, given recent and upcoming policy changes. 

Beginning in January 2026, the GOP’s “One Big Beautiful Bill Act” introduces stringent income verification and work requirements to the Medicaid program, complicating what is often already a complex and lengthy application process.

“It’s a lot of stuff you have to do,” Harris, now 27, said of her experience trying to get on the public health insurance program earlier this year.

The ACA marketplaces also face big changes. Both the “One Big Beautiful Bill Act” and the Trump administration’s “Marketplace Integrity” rule introduce several income and enrollment verification requirements that make it harder to maintain or qualify for subsidized coverage starting in 2026, though the latter is currently tied up in court. Plus, enhanced premium credits, which help low-income Americans afford marketplace plans, are set to expire at the end of 2025. 

“Those are going away if Congress doesn’t extend them,” said Sara Collins, senior scholar and vice president for health care coverage and access at the Commonwealth Fund, which supports research on health care issues. In that scenario, marketplace shoppers are going to see significantly “higher premiums than they otherwise would have.”

Unaffordable Care

In fact, a recent Kaiser Family Foundation analysis found ACA marketplace insurers, on average, are aiming to raise premiums by about 20% in 2026, the largest rate change requested since 2018.

Those increases could easily dissuade young adults from shopping on the exchanges, given that the group is more price-sensitive than other demographics. “They tend to be healthier, and they end up taking a pass,” Collins said.

Annabelle Fisher, a hair stylist in Farmington Hills, Michigan, went through her own struggle finding health insurance after aging off her parents’ plan in May. “Everything I looked at was $500 or more,” she said. “It’s just a heavy cost.”

Fisher ultimately chose the most affordable option she could find, a plan from insurer UMR that offered basic benefits and cost around $300 per month. “To be honest, I don’t even know where I have coverage,” Fisher said. “I feel like I didn’t think too much about it because I’m a pretty healthy person.”

She has plans to join her fiancé’s employer-sponsored health insurance once they get married in September.

What to Do If You’re 26 and Don’t Have Health Insurance

Complicating matters for confused young adults: The Trump-led Centers for Medicare & Medicaid Services (CMS) cut funding to the ACA Navigator program, which provides personalized shopping assistance to people seeking coverage, by 90% earlier this year.

“The Navigator program was a crucial part of helping people [get affordable health insurance], especially those who are underrepresented,” Milam said.

This move places more responsibility on young adults to understand their coverage options, although you can still seek Navigator assistance. 

Here’s an overview of what to do if you age off your parents’ health insurance and don’t have access to employer-sponsored benefits. 

• Visit Healthcare.gov. The federal ACA marketplace is the best place to go to determine what assistance—Medicaid or subsidies—you’re eligible for. It’ll also direct you to your state exchange, if you live where one is run independently from the federal marketplace. Plus, plans you purchase through a state or federal exchange “are ACA-compliant, which means they do cover a comprehensive set of benefits,” Collins said.
• Consider COBRA. Though this option is often quite pricey, you may be eligible to extend health coverage under a parent’s plan for up to 36 months under the Consolidated Omnibus Budget Reconciliation Act (COBRA). 
• Look into a high-deductible health care plan, particularly if you’re on a tight budget. If you end up needing care, HDHPs require you to pay more out-of-pocket before coverage begins, but in exchange, you pay a lower monthly premium. They can be a good option for younger, healthier individuals who don’t anticipate needing much annual care.    
• Join a partner’s plan. Some states require employers to recognize domestic partnerships or civil unions and extend health benefits as they would to official spouses. Employer-sponsored plans may offer the same courtesy, regardless of state law, so it’s worth checking with a partner’s Human Resources department if you are coupled up and in need of coverage.
• Use a short-term health insurance plan. As a last resort, young adults could join a short-term health insurance plan. These plans only last a few months and have reduced benefits, but are substantially less expensive than an ACA plan. This temporary coverage can buy you time until you can afford or qualify for something else.    

Bottom Line

When young adults turn 26, they need to leave their parents’ health insurance plan and buy their own coverage. This is becoming increasingly difficult and expensive due to rising premiums and new government policies, such as reduced premium credits and tougher requirements to join Medicaid. Young adults who don’t have access to workplace benefits can research their options for individual coverage on the ACA exchange, including possible lower-cost high-deductible health plans.