Private Insurance

Health Care Affordability

BTD Health Policy in 2026

Health Policy in 2026

In a new column, 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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  • Calculadora del Mercado de Seguros Médicos

    Feature

    Esta calculadora ilustra las primas (el costo mensual de su seguro) y subsidios para las personas que compran seguro médico por su propia cuenta en el mercado de seguros de salud (o de intercambio) creado por la Ley de Cuidado de Salud a Bajo Precio (Affordable Care Act, ACA, en inglés).

  • Health Insurance Marketplace Calculator

    Feature

    The Health Insurance Marketplace Calculator, updated with 2025 premium data, provides estimates of health insurance premiums and subsidies for people purchasing insurance on their own in health insurance exchanges (or “Marketplaces”) created by the Affordable Care Act (ACA).

  • Insurance Coverage of OTC Oral Contraceptives: Lessons from the Field

    Report

    This report is based on 35 structured interviews conducted from January to August 2023, with nearly 80 experts and key players such as pharmacists, health plans, and state Medicaid officials involved in the coverage and provision of OTC contraception in seven states with one or more of these coverage approaches (IL, NJ, NM, NY, OR, UT, and WA). It discusses the challenges and successes in coverage under private health insurance and Medicaid and reviews policy options for operationalizing insurance coverage of non-prescribed OTC contraception such as Opill.

  • Congressional District Interactive Map: How Much Will ACA Premium Payments Rise if Enhanced Subsidies Expire?

    Issue Brief

    This analysis and interactive map illustrate how much more enrollees in Affordable Care Act (ACA) Marketplace plans would pay in premiums at the congressional district level if the enhanced subsidies were to expire in 2026 as under current law. The tool presents scenarios for an older couple who would lose subsidy eligibility due to their income level and for a single person with a $31,000 income. It also presents net average premium payment increases in each district in states that use Healthcare.gov.

  • Claims Denials and Appeals in ACA Marketplace Plans in 2021

    Issue Brief

    This analysis of HealthCare.gov Marketplace insurers' transparency data finds that 17% of in-network claims were denied in 2021, with denial rates varying widely across insurers. Consumers appealed less than two-tenths of 1% of denied in-network claims.

  • How Private Insurance Works: A Primer

    Report

    This primer, prepared by Gary Claxton of the Institute for Health Care Research and Policy at Georgetown University, examines the structure and operation of private health insurance including the types of organizations that provide it, how managed care is delivered, and how risk pools work and describes how private health insurance coverage is regulated under…

  • 2013 Employer Health Benefits Survey

    Feature

    This annual Employer Health Benefits Survey (EHBS) provides a detailed look at trends in employer-sponsored health coverage, including premiums, employee contributions, cost-sharing provisions, and other relevant information. The 2013 EHBS survey finds average family health premiums rose 4 percent in 2013, relatively modest growth by historical standards.