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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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  • 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…

  • Kaiser Health Tracking Poll – January 2018: The Public’s Priorities and Next Steps for the Affordable Care Act

    Feature

    With the 2018 midterm elections still about ten months away, the January Kaiser Health Tracking poll examines what issues voters most want 2018 midterm candidates to talk about during their upcoming campaigns. Health care is at the top of a group of issues but health care is less important to Republicans and among voters in battleground states. While Congress is currently debating a budget to keep the government funded beyond February 8, 2018, the poll…

  • Analysis: Before ACA Benefits Rules, Care for Maternity, Mental Health, Substance Abuse Most Often Uncovered by Non-Group Health Plans

    News Release

    Three in four health plans in the non-group insurance market did not cover delivery and inpatient maternity care in 2013, before the Affordable Care Act (ACA) essential health benefits requirement took effect, finds a new Kaiser Family Foundation analysis. Other major benefits most often left uncovered before the ACA include substance abuse disorder services (inpatient and outpatient services each not covered by 45% of 2013 non-group plans) and mental/behavioral health services (inpatient and outpatient services…

  • How Many of the Uninsured Can Purchase a Marketplace Plan for Less Than Their Shared Responsibility Penalty?

    Issue Brief

    For people who are uninsured and eligible for Affordable Care Act (ACA) marketplace plans, the analysis compares the cost of a premium for the lowest-cost bronze plan with the estimated individual mandate tax penalty for 2018. It finds that more than half (54% or 5.9 million) of the 10.7 million people could pay less in premiums for health insurance than they would owe as an individual mandate tax penalty for lacking coverage.

  • New Individual Mandate Penalty Calculator Helps Consumers Estimate Their Penalty for Being Uninsured in 2018

    News Release

    A new individual mandate penalty calculator from the Kaiser Family Foundation allows consumers to estimate how much they would owe as a tax penalty for lacking health coverage in 2018, and to compare that amount to the cost of the least expensive 2018 Affordable Care Act marketplace plan in their local area. Using household income, family size, ages of family members, and zip code data, the tool provides a projection of an individual’s penalty for…

  • Public Ranks Children’s Health Insurance, Marketplace Stabilization Higher Priorities than ACA Repeal

    News Release

    Majorities Support Buy-In Ideas for Medicaid and Medicare Among health priorities facing urgent deadlines in Washington in September, the public ranks repeal of the Affordable Care Act lower than reauthorizing funding for the Children’s Health Insurance Program (CHIP) and stabilizing individual health insurance marketplaces established by the ACA, the Kaiser Family Foundation’s new tracking poll finds. About seven in 10 Americans -- and majorities across parties -- say it’s “extremely” or “very” important to reauthorize…

  • The Public, Managed Care and Consumer Protection

    Other Post

    The Kaiser Public Opinion Update -Revised, 2000 This new and revised Public Opinion Update summarizes key findings from surveys conducted between 1997 and 2000, a period in which the intensity of public debate and media attention paid to managed care issues varied substantially. Trends used in this Public Opinion Update are from the following Kaiser Family Foundation/Harvard University, School of Public Health Surveys: September, 1997: Survey of Americans' Views on Managed Care (11/97, #1328); December,…