The internet will tell you that the ACA Marketplace is the go-to for anyone buying their own health insurance. And for people who qualify for meaningful subsidies, that's often true. But there's a large and growing group of self-employed workers, entrepreneurs, and 1099 contractors for whom the ACA Marketplace is actually one of the most expensive options available.
If you earn a solid income — roughly above $58,000 as an individual or $120,000 as a family — you likely receive little to no ACA subsidy. You're paying full unsubsidized Marketplace premiums, which can be just as high or higher than comparable private health insurance. And unlike private plans, you're stuck with whatever carriers participate in your state's Marketplace.
This is exactly the situation where private health insurance becomes the smarter choice — and it's one of Triple Crown Health's specialties.
What Is Private Health Insurance?
Private health insurance is coverage purchased directly from an insurance carrier, completely outside the government Marketplace. It isn't listed on healthcare.gov, isn't subject to Open Enrollment windows, and isn't priced based on your income. Instead it's underwritten based on your health profile — age, health history, and the coverage level you choose.
For healthy, higher-earning individuals and families, this underwriting process typically results in significantly lower monthly premiums than unsubsidized ACA plans — often 20-40% less for comparable coverage.
The Key Advantages of Private Plans for High Earners
- Lower premiums — without subsidy, ACA plans are priced for a broad risk pool. Private plans price for you specifically, which rewards good health.
- Broader carrier options — private plans include carriers that don't participate in the ACA Marketplace, often with larger networks and more plan flexibility.
- Year-round enrollment — no waiting for Open Enrollment. Coverage can begin in as little as 24 hours after approval.
- Customizable coverage — more options to tailor deductibles, networks, and coverage levels to what you actually need.
- No income reporting requirements — ACA plans require income reconciliation at tax time. Private plans have no such complication.
The Tradeoffs to Understand
Private health insurance isn't the right fit for everyone. There are two significant tradeoffs to understand before assuming it's your best option:
Medical underwriting applies. Your health history matters. Pre-existing conditions can affect your premiums or coverage. If you or a family member has significant ongoing health needs, ACA plans — which cannot deny coverage or charge more based on health — may provide better protection regardless of cost.
No guaranteed issue. Unlike ACA plans which must accept all applicants, private carriers can decline coverage based on health history. For most healthy individuals this isn't an issue, but it's important to understand going in.
How Triple Crown Health Approaches This
MacKenzie Wickel doesn't start with a recommendation — she starts with your situation. Income, health profile, the doctors you want to keep, your budget, and how you actually use healthcare. Then she compares both ACA and private options side by side so you can see the real numbers before making any decision.
For most self-employed, high-income clients across Florida, Texas, Maryland, and Illinois — the states where Triple Crown Health writes the most policies — private health insurance ends up being the better fit. But the comparison is always done first, never assumed.
Getting Started
If you're self-employed or a 1099 contractor earning above the ACA subsidy threshold and paying more than you think you should for health insurance — or avoiding it altogether because the prices seem unreasonable — a 20-minute call with MacKenzie is worth your time. Coverage that costs significantly less and starts within 24 hours is a real option for most healthy, higher-earning individuals.
Book a free call with MacKenzie and see what private coverage would actually cost for your situation.