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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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  • Insurer Competition, Monthly Premiums Could Be Affected in Some Markets if UnitedHealth Group Exits ACA Marketplaces

    News Release

    A withdrawal by UnitedHealth Group from the Affordable Care Act (ACA) marketplaces in 2017 could have a significant impact on insurer competition and premiums in some markets, though it would have a minimal effect on the average benchmark premium nationwide, according to a new analysis from the Kaiser Family Foundation. Late last year, UnitedHealth announced that it experienced significant financial losses in ACA compliant plans and that it would decide about future participation in ACA…

  • National ACA Marketplace Signups Dipped a Modest 3.7 Percent This Year

    News Release

    Overall ACA marketplace signups for 2018 dropped by 3.7 percent compared to last year’s enrollment period, a new analysis from the Kaiser Family Foundation finds. 11,760,533 people signed up for 2018 health insurance coverage on the ACA individual marketplaces, amid steep reductions in federal funding for outreach and navigators, an enrollment period half as long, and a climate of political uncertainty surrounding the law. The federal government also terminated cost-sharing subsidy payments to insurers in…

  • Analysis: Cost of Treating Opioid Addiction Rose Rapidly for Large Employers as the Number of Prescriptions Has Declined

    News Release

    A new Kaiser Family Foundation analysis finds that while the use of prescription opioids among people with employer-based health coverage has declined to its lowest levels in over a decade, the cost of treating addiction and overdoses has increased sharply. The annual cost of treating opioid addiction and overdose – stemming from both prescription and illicit use -- has increased by more than eight-fold since 2004, from $0.3 billion dollars to $2.6 billion in 2016.…

  • Analysis: Insurer Financial Indicators Show Signs of Stabilizing After Transition to ACA Marketplaces

    News Release

    A new Kaiser Family Foundation analysis of key insurer financial indicators suggests that the individual insurance market showed signs of stabilizing in 2016, although profitability remained below the level of performance prior to the opening of the Affordable Care Act’s insurance marketplaces. The new analysis tracks insurer financial performance in the individual market through two key indicators: average medical loss ratios (the share of health premiums paid out as claims) and average gross margins per…

  • The Effects of Ending the Affordable Care Act’s Cost-Sharing Reduction Payments

    Issue Brief

    This analysis estimates that total federal spending on Affordable Care Act marketplace subsidies would rise $2.3 billion, or 23 percent, in 2018 if payments for the cost-sharing reduction program were eliminated and insurers increased premiums to compensate. Established to reduce out-of-pocket costs for marketplace enrollees with lower incomes, the cost-sharing payments are being challenged in a lawsuit from the U.S. House.

  • 2018 Renewal Notices – What Marketplace Consumers Need to Know

    Issue Brief

    As Open Enrollment for 2018 coverage gets underway, consumers who have health coverage through the Affordable Care Act (ACA) Marketplace are again receiving renewal notices from their health insurers. Though the insurer renewal notices this year are based on the same model notice required in the past, this year for many consumers, it may be causing significant – and misleading – sticker shock. That is because renewal notices sent by insurers are required to inform…

  • Kaiser Health Tracking Poll – November 2017: The Politics of Health Insurance Coverage, ACA Open Enrollment

    Feature

    This month marks the start of the ACA's fifth open enrollment period and finds three in ten of the public saying they haven't heard anything at all about the current open enrollment period. Despite their overall views of the ACA, the majority of the public (61 percent) – including most Democrats (71 percent), independents (58 percent), and half of Republicans (52 percent) – say that because President Trump and Republicans in Congress are now in…