7 Smart Ways To Cut Costs and Afford Rising Healthcare Bills

Rising health insurance and medical costs are prompting consumers to delay care: a July 2025 Kaiser Family Foundation poll found 36% of adults skipped or postponed needed care in the prior 12 months and 75% of uninsured adults under 65 went without care due to cost. The piece outlines household-level mitigation strategies—shopping pharmacies, using preventative services, reviewing expenses, earning cash back, shopping insurance plans, and cutting impulse spending—that could temper discretionary spending and shift demand toward lower‑cost pharmacies and preventive services, with potential but limited implications for payers, pharmacy margins and consumer discretionary companies.

Analysis

Market structure: Consumers skipping care (~36% per KFF) redistributes volume toward lower-cost channels — discount/retail pharmacies and PBMs (CVS, CI, WBA), telehealth (TDOC) and urgent-care/retail-clinic models. Elective-procedure reliant hospitals and specialty outpatient centers (HCA, SPLK?) are vulnerable to a 5–10% hit to elective volumes over the next 6–12 months if skip rates persist above ~30%, reducing pricing power for high-cost providers.

Risk assessment: Tail risks include aggressive federal drug-price negotiation/Medicare expansion or state-level Medicaid expansions within 12–24 months that compress pharma margins, and provider insolvencies if receivables rise >15% year-over-year. Immediate (days) sensitivity will show in retail pharmacy footfall and consumer-credit delinquencies; short-term (weeks–months) catalysts are insurer and hospital earnings and monthly CPI/medical inflation prints; long-term (years) is chronic-disease cost creep if preventative care is deferred.

Trade implications: Favor PBM/retail pharmacy exposure (CVS, CI, WBA) and low-cost telehealth (TDOC) while underweight elective-hospital operators (HCA) and specialty outpatient REITs. Implement modest, timed positions: enter within 2–6 weeks ahead of insurers' next earnings; use options to hedge execution risk (see decisions). Rebalance away from discretionary consumer and elective healthcare into staples/low-cost care names.

Contrarian angles: Consensus understates the probability of a sharp rebound — historically post-crisis elective volumes rose 10–15% as deferred demand hits — so short positions on hospitals risk a 1–2 quarter squeeze if skip rates normalize below 25%. Conversely, if policy (drug pricing/coverage) accelerates within 12–24 months, PBM/retail upside could be capped; monitor KFF skip rate, CMS outpatient volumes and state policy moves as binary triggers.

Key Decisions for Investors

• Establish a 1.5–2.5% long position in CVS Health (CVS) over the next 2–6 weeks to capture PBM + retail pharmacy share gains; size to 1.5% if portfolio concentrated in healthcare, add to 2.5% if diversified. Set stop-loss at -12% and target +20% over 6–12 months, or earlier on a positive earnings surprise.
• Initiate a 1.5–2% short position in HCA Healthcare (HCA) to reflect a potential 5–10% elective volume contraction over 6–12 months; hedge with 3-month 10/20% put spreads (buy 10% OTM put, sell 20% OTM) to limit downside and cap cost. Cover if hospital outpatient volumes rebound >5% QoQ or if skip-rate falls below 25% in two consecutive months.
• Pair trade: Long 1% Cigna (CI) vs short 1% HCA to play PBM/insurer capture of low-cost care; monitor Express Scripts margin trends and insurer medical-loss ratios — exit if MLR widens by >200bps vs guidance in next two earnings reports.
• Options play: Buy a 6–12 month call spread on Teladoc (TDOC) sized at 0.5–1% notional (e.g., buy ATM, sell +30% OTM) to express low-cost telehealth adoption; target >30% upside if telehealth monthly active users grow >10% QoQ, cut if growth stalls 2 consecutive quarters.