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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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  • Premiums and Worker Contributions Among Workers Covered by Employer-Sponsored Coverage, 1999-2020

    Interactive

    This graphing tool allows users to explore trends in workplace-sponsored health insurance premiums and worker contributions over time for different categories of employers based on results from the annual Employer Health Benefits Survey. Breakouts are available by firm size, region and industry, as well as for firms with relatively few or many part-time workers, higher- or lower-wage workers, and older or younger workers.

  • Individual Insurance Market Performance in 2019

    Issue Brief

    New data from 2019 suggest that insurers in the individual market remain profitable, even with average premiums falling for the first time since the ACA was implemented. These data indicate that the individual market appears to be stable in 2019, despite the repeal of the individual mandate penalty and the proliferation of loosely-regulated short-term insurance plans.

  • Analysis Finds List Prices for COVID-19 Tests Range from $20 to $850 At Large Hospitals Nationwide

    News Release

    A new KFF analysis of what large hospitals nationwide charge for out-of-network COVID-19 tests show a wide range of publicly posted prices -- from $20 to $850 for a single test. In many cases, the prices exceed what Medicare pays for COVID testing, which is either $51 or $100 depending on the test. Federal law now requires private insurers, Medicare and Medicaid to cover COVID-19 tests without any cost to the patient and provides funding…

  • Pre-existing Conditions: What Are They and How Many People Have Them?

    Policy Watch

    Facing a challenge now before the Supreme Court, the Affordable Care Act (ACA) included provisions to protect people with pre-existing conditions from discrimination in the individual employment market. This post explains what pre-existing conditions are and the different estimates for the number of people who have them.

  • KFF Health Tracking Poll – October 2020: The Future of the ACA and Biden’s Advantage On Health Care

    Report

    The poll examines the public's views on the Supreme Court case to overturn the Affordable Care Act and its protections for people with pre-existing conditions. Less than a month from the results of the 2020 presidential election, this poll examines the top issues for voters (the economy, the coronavirus pandemic, health care, criminal justice and policing, among others) as well as which candidate, Biden or Trump, they think has the better approach to handle key…

  • Millions of Uninsured Americans are Eligible for Free ACA Health Insurance

    Policy Watch

    Amid the ongoing pandemic and high unemployment, this poste xamines how many uninsured people would be eligible for free health insurance during in a typical year, including those who qualify for Medicaid or for tax credits that cover the full cost of an ACA Marketplace plan.

  • How Has the Pandemic Affected Health Coverage in the U.S.?

    Policy Watch

    Findings from administrative data suggest that the decline in enrollment among employer-sponsored insurance was far less than overall declines in employment as of September, and that many who did lose their job-based coverage likely found a safety net in coverage through Medicaid or the ACA marketplaces.