You don't need to have traditional "insurance" to be exempt from penalty under PPACA. There are exemptions for members of certain groups (IIRC, Native American

You don't need to have traditional "insurance" to be exempt from penalty under PPACA. There are exemptions for members of certain groups (IIRC, Native American tribes and religious groups that are opposed to the concept of insurance, like the Amish). There are also exemptions for participants in "health cost sharing ministries" [0]. My family pays $135/month for what, practically, functions like a high-deductible plan [1] -- a little more expensive than just paying the penalty, but it's worth it to mitigate the cost risk associated with catastrophic illness. [0] http://en.wikipedia.org/wiki/Health_care_sharing_ministry http://en.wikipedia.org/wiki/Health_care_sharing_ministry . There's a list of Christian health-sharing ministries at http://www.healthcaresharing.org/ http://www.healthcaresharing.org/ ; I don't know what other religions or non-religions might have similar programs. [1] the friend who referred me to this signed up for a no deductible option. He was diagnosed with cancer a month later, and they covered everything.