Private Insurance

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How Much and Why ACA Marketplace Premiums Are Going Up in 2026

A new analysis of initial rate filings for Affordable Care Act (ACA) Marketplace plans submitted by 312 insurers in all 50 states and the District of Columbia finds the median proposed increase for 2026 is 18%, more than double last year’s 7% median proposed increase. The proposed rates are preliminary and could change before being finalized in late summer. In addition to rising cost and utilization of services, insurers cited the expiration of enhanced premium tax credits as a significant factor in their rate hikes for next year.

Quick Take

Tariffs Are Driving 2026 Health Insurance Premiums Up

2025 Reconciliation Bill

Health Savings Account Provisions in the 2025 Tax and Spending Law

analysis

Health Insurer Financial Performance in 2023

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Consumer Experiences with Health Insurance

Employer Coverage

Employer Family Premiums Climb to $25,572 in 2024, Survey Finds

Family premiums for employer-sponsored health insurance rose 7% in 2024, matching the 2023 increase, KFF's benchmark Employer Health Benefits Survey finds. Over the previous five years, the cumulative increase in premiums has been similar to the rise in general inflation and workers' wages. The survey also examines deductibles and other cost-sharing, coverage of GLP-1 weight-loss drugs, and more.

Read the News Release

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Projected Surge in Uninsured Will Strain Local Health Systems
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Watch: Why Is Having a Baby So Expensive in the US?

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Women who Give Birth Incur Nearly $19,000 in Additional Health Costs, Including $2,854 More that They Pay Out of Pocket

Jul 13, 2022
News Release

The health care costs associated with pregnancy and childbirth average almost $19,000, including $2,854 paid out-of-pocket, a new KFF analysis of large employers’ insurance claims finds.
ACA’s Maximum Out-of-Pocket Limit Is Growing Faster Than Wages

Jul 20, 2022
Issue Brief

This analysis finds that the ACA’s maximum out-of-pocket limit is likely to grow faster than wages and salaries, and is also expected to grow faster than the maximum out-of-pocket limit for Health Savings Account (HSA)-qualified health plans.
Outpatient Visits Are Growing More Complex: Implications for Health Costs

Feb 27, 2023
Issue Brief

This analysis for the Peterson-KFF Health System Tracker uses claims data from private, large employer-based plan to examine trends in complexity coding across outpatient practice settings from 2004 to 2021. It finds a trend toward higher complexity codes that contributes to higher outpatient spending.
Medicare Advantage Insurers Report Much Higher Gross Margins Per Enrollee Than Insurers in Other Markets

Feb 28, 2023
News Release

A new analysis of health insurers’ 2021 financial data shows that insurers continue to report much higher gross margins per enrollee in the Medicare Advantage market than in other health insurance markets. The analysis examines insurers’ financial data in the Medicare Advantage, Medicaid managed care, individual (non-group), and fully insured group (employer) markets.
Preventive Services Use Among People with Private Insurance Coverage

Mar 20, 2023
Issue Brief

This analysis of claims data estimates that six in ten people with private health insurance - or about 100 million people - used at least one preventive service covered without any out-of-pocket costs through a provision of the Affordable Care Act (ACA) in a typical year prior to the COVID-19 pandemic (2018).
How Do Facility Fees Contribute To Rising Emergency Department Costs?

Mar 27, 2023
Issue Brief

With the high costs of emergency department visits of significant importance to consumers and policymakers, this analysis examines claims data from privately insured individuals with large employer health plans, to examine the role that facility fees play in rising cost of emergency care.
Increasingly Privatized Public Health Insurance Programs in the US

Mar 30, 2023
Perspective

In this JAMA Forum column, KFF’s Larry Levitt examines the growing role of private insurance companies in public programs, including Medicare Advantage and Medicaid managed care, and the tradeoffs that result.
Five Things to Know about the Renewal of Extra Affordable Care Act Subsidies in the Inflation Reduction Act

Aug 11, 2022
Policy Watch

As part of the Inflation Reduction Act, the Senate recently passed a three-year extension (through 2025) of enhanced subsidies for people buying their own health coverage on the Affordable Care Act Marketplaces. The enhanced subsidies increase the amount of financial help available to those already eligible and also newly expand subsidies to middle-income people, many of whom were previously priced out of coverage. Here’s what to know about the likely renewal of these subsidies:
Cost of COVID-19 Hospital Admissions among People with Private Health Coverage

Nov 14, 2022
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.
Emergency Department Visits Exceed Affordability Threshold For Many Consumers With Private Insurance

Dec 16, 2022
Issue Brief

This analysis uses 2019 insurance claims data from large employer health plans to assess the total and out-of-pocket costs of emergency department visits, overall and by diagnosis and severity level. It also looks at which services contribute most to the costs of emergency department visits.

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Listen: The Surprising Power of Pushback When Health Insurance Won’t Pay

Team Trump’s Answer to Ballooning Obamacare Premiums: Less Generous Coverage

Projected Surge in Uninsured Will Strain Local Health Systems

Under Trump, FDA Seeks To Abandon Expert Reviews of New Drugs

Watch: Why Is Having a Baby So Expensive in the US?

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