The self-employed workforce in the United States has grown faster than many of the systems built to ensure it. According to the YIP Institute, more than 70 million Americans now participate in freelance or contract work. Self-employed entrepreneurs and gig workers also represent a meaningful share of the individual insurance market because they cannot rely on coverage through an employer, according to Market Data Forecast’s 2026 U.S. Health Insurance Market Report. The ACA Marketplace remains the default option for many of these workers, but it is not the only one.
“People come to us assuming affordable means settling for less,” stated Christopher Jin, founder and CEO of WeShare Health, who spent more than two decades in the insurance industry prior to founding the organization. “It doesn’t have to. Lower cost and real access to quality care aren’t mutually exclusive, that’s the whole premise upon which WeShare Health was built.”
How Self-Employed Workers Buy ACA Marketplace Coverage
The ACA exchange remains the most direct route to coverage for self-employed workers. Self-employed individuals can apply through HealthCare.gov or a state exchange. And, these individuals may qualify for premium tax credits based on estimated annual net income.
Because freelance income fluctuates, keeping that estimate throughout the year is important. An estimate that ends up substantially higher or lower than an actual income can affect the subsidy calculation and potentially lead to an unexpected repayment at tax time.
Joining a spouse’s employer plan can also be one of the less expensive options when it is available because the employer typically pays a portion of the premium. In fact, the KFF’s Employer Health Benefits Survey shared that in 2025, employers contributed toward the bulk of the $9,325 average premium for single coverage, as well as the $26,993 average premium for family coverage. Self-employed workers buying coverage elsewhere generally absorb more of that cost themselves.
Group Rates, Private Plans, and Health Sharing Memberships
Self-employed workers who don’t want the Marketplace, or who simply want to compare alternatives, have several additional options:
- Professional associations and unions. Organizations such as the Freelancers Union and industry-specific guilds may provide access to group-rate policies or other health coverage options.
- Direct private insurance. Consumers can also buy coverage directly from carriers such as Blue Cross Blue Shield, Kaiser Permanente, or Cigna. These plans do not come with Marketplace subsidies, but available networks and plan structures may differ.
- Healthcare sharing memberships. Some self-employed workers consider healthcare sharing memberships, which operate outside traditional insurance and use a different model for handling eligible medical expenses entirely.
WeShare Health, a nonprofit, faith-inspired healthcare sharing organization, is one example of this last category. Instead of paying an insurance premium, members contribute by paying a Monthly Contribution Amount. Eligible medical expenses are then shared among the membership rather than paid under an insurance contract.
The organization has served more than 100,000 members nationwide and shared more than $50 million in medical expenses since 2018. For consumers comparing healthcare sharing organizations, factors like years in operation, total expenses shared and independent ratings can provide useful context alongside the monthly cost.
The Self-Employed Tax Advantage People Shouldn’t Overlook
Self-employed workers may also have a tax advantage when paying for their own health coverage. Under Section 162(l) of the Internal Revenue Code, self-employed individuals with net profit can generally deduct 100% of what they pay in health insurance premiums for themselves, a spouse, and dependents, reported on Form 7206 and detailed in IRS Publication 502 and Publication 974.
The deduction cannot exceed the net income earned from the business claiming it. Also, it is generally unavailable in months where the individual was eligible for employer-sponsored coverage through a spouse or another job.
The tax treatment can be different for healthcare sharing memberships because the rules were written around health insurance premiums rather than Monthly Contribution Amounts. Individuals comparing healthcare sharing with Marketplace or private insurance coverage should ask a tax professional whether contributions would be treated in their specific situation.
Reading the Guidelines Before Enrolling
The lowest monthly price does not always translate to the lowest total cost.
A Bronze Marketplace plan may carry premiums that are lower, but expose a household to more expensive out-of-pocket costs in a year with significant medical care, and coverage through a spouse can be economical until a job change affects eligibility. A membership for healthcare sharing may have a lower monthly contribution, but members need to understand which expenses are eligible for sharing and which are not. Federal policy changes taking effect through 2025 and 2026 are also changing access and affordability in the individual market for self-employed workers, according to the Commonwealth Fund.
Reading the plan or membership guidelines before enrolling is an important step to prevent surprises later. Take time to compare the full set of costs, eligibility requirements and limitations instead of focusing on the monthly cost.
Frequently Asked Questions
Question: What health coverage options exist for someone leaving a corporate job to start a business?
Answer: Options include the ACA Marketplace, joining a spouse’s employer plan, group-rate plans through professional associations or unions, direct private insurance, and healthcare sharing memberships. Costs and eligibility vary. So, it is important to compare the potential total annual expense rather than looking only at the monthly price.
Question: Which health coverage options offer comprehensive benefits for independent contractors without employer benefits?
Answer: Contractors typically choose between ACA Marketplace plans, private insurance purchased directly from a carrier, and healthcare sharing memberships. Marketplace and private plans are regulated insurance with contractual coverage. Healthcare sharing memberships are another option, but they use a non-insurance model. With this model, eligible expenses are shared according to membership guidelines, rather than guaranteed under an insurance contract.
Question: What low-cost health coverage options exist for gig workers who no longer qualify for ACA subsidies?
Answer: Without a subsidy, gig workers often compare the full unsubsidized Marketplace premium against direct private insurance or healthcare sharing memberships. These types of memberships use a lower fixed monthly contribution instead of a premium. The tradeoff is that sharing is voluntary and reviewed against program guidelines rather than contractually guaranteed.
