Jessica Balcerzak works as a nurse. She spends her days in a hospital in Buffalo, New York, observing firsthand how the American healthcare system functions, including the billing codes, coverage gaps, and fine print that subtly undermines patients’ perceived security. Nevertheless, she decided to completely discontinue her employer’s health insurance last year, which shocked even a few of her colleagues.
Fifty-five percent of her premiums were paid by her hospital. Until you do the math, that seems generous. For a young, healthy family that, as she told Bloomberg, didn’t really use the coverage much, the remaining 45% still came to $585 every two weeks, or more than $15,000 annually. “We’re healthy,” she declared. “I wish we were given some benefit from the healthcare that we do have to work for.” In order to save about $970 a month, she and her husband signed the children up for a state-sponsored plan and joined Zion HealthShare, a medical cost-sharing cooperative, for $297 a month. Back in the family budget, nearly $12,000 annually.
She’s not by herself. A gradual but noticeable change is taking place across the nation. According to data from the Kaiser Family Foundation, the percentage of employees who sign up for employer-sponsored health benefits has decreased from 70% in 2001 to 61% in 2025. That is a direction rather than a collapse. Additionally, the direction is important, particularly as premiums continue to rise. The average annual cost of single-person insurance is now $9,235, up 5% from the previous year. The cost of family coverage is currently close to $27,000, a 26% increase over the previous five years. That math is no longer clear to many employees.
There is a perception that employers have been sluggish to recognize the true state of their workers’ bank accounts. Myranda Cleary, a Kansas City-based healthcare consultant, sees it every day. “Everything has increased,” she told Bloomberg, characterizing what she refers to as a “perfect storm”—the moment when household financial strain and growing expenses finally force individuals who would otherwise reenroll passively to start asking more difficult questions. According to Cleary, employees who previously took premium increases for granted are now closely examining every dollar. It’s possible that the decades-long dominance of employer-sponsored health plans is finally beginning to give way.
However, abandoning traditional insurance has serious repercussions that are not captured by a monthly savings figure. Health sharing plans are not insurance because coverage is never guaranteed and they are not governed by the same federal and state laws. Instead, it is up to the member community’s judgment. Plans frequently reflect particular religious values, according to a Forbes review of these alternatives, so claims related to what some plans refer to as “non-Biblical lifestyles” can be easily refuted. Balcerzak joined Zion HealthShare, which states that mental health care is not eligible for sharing.
Treatments for allergies, medications for diabetes, evaluations for autism and ADHD, and chronic conditions deemed medically stable also fall under this category. Similar gaps, including limitations on preexisting conditions, were discovered throughout the industry in a 2023 Government Accountability Office study.
The subtle tension in all of this is difficult to ignore. For some of the very people it is meant to protect, the benefit that routinely ranks higher in American workplace surveys than pay raises, vacation time, and remote work flexibility is getting too costly. Healthy workers are running their own actuarial tables and deciding they would prefer to keep the premium difference. This is especially true for young families with low medical utilization. Employers face an uncomfortable consequence: if the majority of the workers they lose from their insurance pools are healthy, the risk pool that remains gets older and sicker, which tends to drive up premiums even further, accelerating the very cycle that drives people away.
There isn’t a simple solution in this case, and anyone thinking about discontinuing employer-sponsored insurance should carefully consider their options before taking Balcerzak’s route. The savings are genuine. However, the exposure is equally significant; one unanticipated diagnosis, one mishap, and those cost-sharing disparities quickly become extremely intimate.
