Not long ago, having health insurance meant having access to care. That assumption is increasingly becoming a thing of the past.
The structure of American health coverage has shifted in ways that quietly moved the financial burden of medical treatment onto the patient. Deductibles have climbed steadily for over a decade. According to the Kaiser Family Foundation’s 2025 Employer Health Benefits Survey, the average annual deductible for single coverage now sits at $1,886, up 43% over the past decade and 17% in just the last five years. Workers at smaller firms face even steeper numbers, averaging $2,631 before coverage kicks in. And those are just the averages. Plenty of people enrolled in high-deductible health plans are looking at thresholds of $5,000 or more before their insurer covers a dime.
That structure creates a predictable problem when someone gets hurt.
Financial Pressure Starts Earlier Than Later
As I discussed with Eric Schuller, president of the Alliance for Responsible Consumer Legal Funding, on The Advisor Podcast, the financial pressure after an injury often starts before a case ever reaches settlement. For many injured consumers, the immediate barrier is not a lack of insurance. It is the deductible, the lost income and the out-of-pocket costs that stand between them and the care they need.
In that conversation, Eric pointed to one of the clearest ways this gap is showing up: injured consumers are increasingly using legal funding to meet high deductibles. Take someone, for example, who needs treatment right away but can’t access coverage until they’ve met a $5,000 deductible — legal funding is increasingly being used to cover that cost while their case is pending.
My point was that this deductible pressure is part of a larger access-to-care problem after an injury. People are often hurt, out of work, unsure where to turn for follow-up care, and facing bills before their case has begun to move through the legal process. Legal funding can help stabilize that early period so a person is not forced to delay treatment or settle too soon simply because they cannot absorb the upfront cost.
The takeaway here? The deductible problem becomes more than a benefits issue. It becomes the first financial obstacle in the recovery process.
The Gap Between Coverage and Care
Bankrate’s 2026 Emergency Savings Report reports more than one in two (59%) adults could not cover a $1,000 unexpected expense with savings alone. Less than half of U.S. adults have enough set aside to cover three months of expenses. The median household savings balance is $8,000, but that number is skewed upward by higher earners. For many working families, the realistic figure is far lower.
The result is a gap. Insurance exists, but it does not activate until a threshold is met that many people cannot afford to reach. And the consequences of waiting are real. KFF data from 2024 shows that 1 in 6 American adults reported delaying or forgoing medical care due to cost, with that figure higher among people who are already managing medical debt. Delayed treatment does not make injuries less serious. In many cases it makes them more complicated to treat, more expensive to resolve and more difficult to document for legal purposes.
Insurance Structure Is Driving Patient Behavior
It is worth being clear about what is actually happening here. These decisions are not irrational. When a person faces a deductible they cannot pay, delaying care is not a failure of willpower or planning. It is a rational response to a financial constraint. The insurance system has, in practice, created a waiting period before benefits apply, and that waiting period falls entirely on the patient.
The ACA marketplace makes this even more pronounced. KFF analysis from 2026 found the average marketplace deductible jumped 37% in a single year, reaching $3,786 as enhanced premium tax credits expired. Consumers caught between rising premiums and higher deductibles are making difficult tradeoffs. Many are choosing lower-premium plans to keep monthly costs manageable, which almost always means accepting a higher deductible. It is an entirely rational decision until an unexpected injury forces them to confront the consequences.
For attorneys and healthcare providers, this matters. Because it directly affects when and how patients enter the system. Clients who delay treatment because they cannot meet their deductible arrive later, with more complex cases, and often without a clean medical record that accurately reflects the early phase of their injury. That gap in documentation creates evidentiary problems in litigation and can affect the value of a claim. It also creates a more difficult recovery path.
Funding That Bridges the Early Phase
Consumer legal funding has historically been used to help plaintiffs manage living expenses while a case works through the legal process. Rent, utilities, groceries, the ordinary costs of staying afloat when income is interrupted. That role has not changed. But the deductible problem has added another layer to what funding is being used for.