Millions of People Are About to Lose Their Health Coverage. Most Don't Know It Yet.

I wrote a whole book about hospital bills because I got tired of watching people get blindsided by them.

Not because they were careless. Not because they ignored their health. Because the system is confusing on purpose, and nobody ever taught us how it works.

That book is still good. Everything in it is still correct. But some things have changed recently that I need to tell you about. Because if you are dealing with medical bills right now, or you are worried about being able to afford care, some of this affects you directly.

I am going to keep this simple. No fancy words. Just what you need to know.

If you buy your own health insurance, don't get attached to what you have.

Some people get insurance through a job. Some people buy it themselves, usually through a government website, and they might get help paying for it depending on how much money they make.

One of the biggest insurance companies in the country (Cigna) just said it is walking away from that market at the end of this year. That affects about 369,000 people.

If you buy your own insurance(not through a job), do not assume your plan will still be there next year. Check. Ask someone at your local library or community center if you need help. Do not wait until the last minute, because the plans that replace what is leaving might cost more or cover less.

If you have free or low-cost government health coverage, you may need to do something to keep it.

Some people have health coverage that is free or very low cost because of how much money they make. It goes by different names in different states. Some people call it Medicaid. Some people just know it as the coverage they got when they went to the health department or applied online.

Here is what is new. Some states are starting to say that adults have to prove they are working, volunteering, or going to school to keep that coverage. At least 80 hours a month. The first state started doing this on May 1st of this year. More states are planning to follow. Nebraska — May 1, 2026 (already live). Montana — July 1, 2026. Arkansas — July 1, 2026, soft launch (they start checking compliance but it's not full enforcement yet). Iowa — December 1, 2026.

If you have this kind of coverage, call the number on your insurance card or go to your state's health department website and find out if your state has this new rule. Do not wait for a letter in the mail. By the time it arrives, you might already be behind.

If you lose this coverage and you get sick, the bills can be devastating. This is worth one phone call.

If you live somewhere that feels far from everything, your local hospital may be in trouble.

This one is hard to say, but I am going to say it.

Hospitals in small towns and rural areas are struggling. Some of them are losing money every single month just to keep their doors open. When they run out of options, they start cutting services. Sometimes they close the maternity ward. Sometimes they close the emergency room. Sometimes they close completely.

Right now, there are conversations happening in Washington about cutting the money that helps keep these hospitals running.

If your nearest hospital is more than 30 minutes away, this matters to you. Pay attention to your local news. If your hospital is struggling, you will start to hear about it.

More people are going without insurance right now. If you're uninsured, you are not alone.

Early this year, one of the biggest hospital systems in the country said they are seeing 15% more patients who have no insurance at all. That number jumped fast.

Some of those people lost their coverage when it got too expensive to keep. Some never had it. Some do not know they might qualify for help.

If you do not have insurance right now, there are still options. Community health centers will see you based on what you can afford to pay. Many hospitals have programs to help people who cannot pay, but they do not always advertise them. You have to ask.

And here is the thing I want you to hear:

If you get a bill you cannot pay, do not just ignore it and hope it goes away. Call the hospital and say those exact words: "I cannot afford this bill. What help do you have available?" That question is free to ask. The answer might surprise you.

The most important thing has not changed.

You have more power than you think when it comes to medical bills.

You can ask for a detailed list of every charge. You can question things that look wrong. You can ask for help paying. You can say you cannot afford it and ask what they can do.

None of that costs you anything. And most people never do it because nobody told them they could.

That is exactly why I wrote the book. Because you deserve to walk into that conversation knowing you have options.

If you already have a copy, pull it back out. There is stuff in there you probably need right now.

If you do not have one yet, grab it here. And if you are staring at a bill right now and you do not know what to do, reply to any of my emails. I will help you figure it out.