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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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  • Workers Wary of Wellness Programs that Tie Premiums to Participation and Outcomes

    News Release

    June Poll Finds No Change in Public's Overall View of the Affordable Care Act Most in Military Households Say VA Problems Are Systemic and Care Not As Good As What Other Americans Receive  As many employers begin to expand their wellness programs under new guidelines set forth by the Affordable Care Act (ACA), the latest Kaiser Health Tracking Poll finds workers oppose programs that make them pay higher premiums if they fail to participate or…

  • A Perilous Gap in Health Insurance Literacy

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman discusses how progress in expanding coverage requires greater attention to the problem of health insurance literacy.

  • 2016 Survey of Health Insurance Marketplace Assister Programs and Brokers

    Report

    In its third year, the survey tracks the experiences of assistance programs signing people up for Affordable Care Act coverage during open enrollment and, for consumers who qualify, during special enrollment periods. This year, for the second time, the survey includes health insurance brokers who helped people apply for non-group coverage in an ACA marketplace.

  • Pre-Existing Condition Prevalence for Individuals and Families

    Issue Brief

    This analysis estimates that almost 54 million people – or 27% of all adults under 65 —have pre-existing health conditions that would likely have made them uninsurable in the individual markets that existed in most states before the Affordable Care Act. Almost half (45%) of non-elderly families include at least one adult with such a pre-existing condition. The analysis also includes estimates by age, state and gender.

  • Among People with Employer Coverage, Those with Persistently High Spending for Several Years Averaged Almost $88,000 in Health Spending in 2017    

    News Release

    Among people with three consecutive years of coverage from a large employer, just 1.3 percent of enrollees accounted for 19.5 percent of overall health spending in 2017, finds a new KFF analysis. These “people with persistently high spending” – people in the top five percent of spending in each of the three years from 2015 to 2017 – had average health spending of $87,870 in 2017. That compared to average per person spending of $5,870…

  • The Silent Affordability Crisis Facing Sick People

    From Drew Altman

    In this Axios column, Drew Altman shows that employer coverage for lower wage workers is much worse than ACA marketplace coverage for similar populations. It’s a bigger problem we need to talk about more, he says.

  • Health Care Costs as Much as a New Car

    From Drew Altman

    Health care for a family covered by a large employer cost, on average, $22,885 last year. That’s $2,000 more than the sticker price for a brand-new Volkswagen Beetle. Drew Altman discusses why it matters in this Axios column.