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Hospital Prices Have Risen Much Faster for Private Insurance Than Medicare Since 2019

Hospitals account for nearly one-third of US health spending and 40% of spending growth from 2022-2024. Analysis shows hospital prices paid by private insurers have risen faster than Medicare rates since 2019, a trend with implications for affordability.

Hospital prices paid by private insurers rose 30% from 2019-2026, compared to a 21% increase in Medicare payment rates. The disparate growth widened an existing gap between what Medicare and private plans pay for hospital services.

What Are the Recent Trends in Employer-Based Health Coverage?

Policy Changes Bring Renewed Focus on High-Deductible Health Plans

Health Insurer Financial Performance in 2024

Examining Short-Term Limited-Duration Health Plans

Health Care Affordability

BTD Health Policy in 2026

Health Policy in 2026

President and CEO Dr. Drew Altman forecasts eight things to look for in health policy in 2026. “First and foremost,” he writes, “is the role health care affordability will play in the midterms.” And, he notes: “The average cost of a family policy for employers could approach $30,000 and cost sharing and deductibles will rise again after plateauing for several years.”

View all of Drew’s Beyond the Data Columns

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  • Americans’ Health Priorities Diverge From Washington’s Focus on Obamacare

    News Release

    In his latest column for The Wall Street Journal's Think Tank, Drew Altman finds the public’s health-care priorities have more to do with drug costs and other real-world issues people deal with using the health-care system than the ongoing partisan wrangling over the Affordable Care Act. All previous columns by Drew Altman are available online.

  • How Have Insurers Fared Under the Affordable Care Act?

    Perspective

    This analysis tracks the financial performance of insurers in the individual market by evaluating trends in the medical loss ratio (MLR) in the pre-ACA landscape from 2010 to 2013 and estimates the MLR for the first full year of Affordable Care Act implementation in 2014. Findings suggest that although performance varied among insurers, insurers overall had roughly comparable financial performance in 2014 as in recent prior years.

  • Explaining Texas v. U.S.: A Guide to the 5th Circuit Appeal in the Lawsuit Challenging the Affordable Care Act 

    News Release

    The outcome of the Texas v. U.S. legal challenge to the Affordable Care Act (ACA) could have far-reaching consequences for the nation’s health system, from rolling back the expansion of Medicaid to removing protections for people with pre-existing conditions and revoking the ability of adult children to stay on their parents’ insurance plans up to age 26. In December, U.S. District Judge Reed O’Connor invalidated the entire ACA after finding the individual mandate unconstitutional. Today,…

  • A Look at People Who Have Persistently High Spending on Health Care

    Issue Brief

    This analysis looks at the amounts and types of health spending for people with employer-based health insurance who have continuing high health care spending. It finds that, among people with three consecutive years of coverage from a large employer, just 1.3 percent of enrollees accounted for almost 20 percent of overall spending in 2017. This group – people in the top five percent of spending in each of the three years from 2015 to 2017…

  • KFF Health Tracking Poll – July 2019: The Future of the ACA and Possible Changes to the Current System, Preview of Priorities Heading Into 2nd Democratic Debate

    Feature

    This month's KFF Health Tracking Poll explores public opinion towards a government-administered public option, and finds that attitudes can change after hearing common arguments. The poll also examines the public's views toward Medicare-for-all and the Affordable Care Act, as well as the top issues for Democrats ahead of the second round of presidential debates.

  • A Small Group of Patients Account for a Whole Lot of Spending

    From Drew Altman

    You have heard about the 5% of the population responsible for 50% of spending. Meet the 1.3%--persistent high spenders with very complex medical needs responsible for 20%. Drew Altman discusses this and possible ways to help them, read the Axios column.

  • Financial Performance of Medicare Advantage, Individual, and Group Health Insurance Markets

    Issue Brief

    Three key private health insurance markets -- Medicare Advantage, the individual market and the fully-insured group market -- appear to be financially healthy and attractive to insurers. The private Medicare Advantage market generates significantly larger gross margins per person than the individual market or fully-insured market. The future of these markets has become a focus for policymakers amid the debate over Medicare for All.

  • The ACA is Doing Fine Without a Mandate Penalty

    From Drew Altman

    In an Axios column, Drew Altman explains that the elimination of the Affordable Care Act’s individual mandate penalty has had little impact on how the ACA’s insurance markets are working, showing that “the marketplaces continue to function, even when 'severed' from the mandate penalty,” and undercutting a central argument in the lawsuit seeking to strike down the entire law.

  • Analysis: 4.7 Million Uninsured People Nationally Could Get a No-Premium Bronze Plan in the ACA Marketplace,Though Deductibles Would be High

    News Release

    As the Affordable Care Act’s open enrollment period nears an end in most areas this week, a new KFF analysis finds that 4.7 million currently uninsured people could get a bronze-level plan for 2020 and pay nothing in premiums after factoring in tax credits, though the deductibles would be high. That works out to 28 percent of the 16.7 million uninsured individuals who are potential customers for coverage through ACA marketplaces. Half of the uninsured…