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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  • 2024 Medical Loss Ratio Rebates

    Issue Brief

    Insurers estimate they will pay $1.1 billion in Medical Loss Ratio (MLR) rebates in 2024 to select individuals and employers that purchase their health coverage, according to a KFF analysis of preliminary data reported to state regulators. The estimated rebate for 2024 is larger than rebates issued in most prior years. Nearly $12 billion in rebates have been issued since 2012.

  • Cost of COVID-19 Hospital Admissions among People with Private Health Coverage

    Issue Brief

    This analysis examines the cost of COVID-19 treatment for inpatient care among people with health coverage through large employers. It finds that in 2020, COVID-19 hospitalizations cost an average of $41,611, including an average out-of-pocket payment of $1,280 for people with large employer coverage.

  • Navigating the Family Glitch Fix: Hurdles for Consumers with Employer-sponsored Coverage

    Issue Brief

    About 5 million people could benefit from the fix to the Affordable Care Act’s “family glitch” that allows workers offered unaffordable family coverage to get subsidies in the marketplace – if they can show they qualify. This brief looks at some of the challenges consumers may face in deciding whether to take advantage of the fix.

  • The Requirement to Buy Coverage Under the Affordable Care Act

    Other

    Note:  Congress eliminated the federal tax penalty for not having health insurance, effective January 1, 2019. Along with changes to the health insurance system that guarantee access to coverage to everyone regardless of pre-existing health conditions, the Affordable Care Act includes a requirement that many people be insured or pay a penalty.

  • Employer Responsibility Under the Affordable Care Act

    Other

    The Affordable Care Act does not require businesses to provide health benefits to their workers, but applicable large employers may face penalties if they don’t make affordable coverage available. The employer shared responsibility provision of the Affordable Care Act penalizes employers who either do not offer coverage or do not offer coverage that meets minimum value and affordability standards. These penalties apply to firms with 50 or more full-time equivalent employees. This flowchart illustrates how those employer responsibilities work.