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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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  • “Deductible Relief Day” is May 19

    News Release

    Deductible Relief Day is May 19. That’s the date by which average spending for people with employer-sponsored health insurance is sufficient to satisfy the average deductible, the amount they must pay out-of-pocket for most health care services before their insurance plan kicks in to help pay the bills, KFF analysts explain in a new analysis. If you have not heard of Deductible Relief Day before, that is because we just invented it. But the issue…

  • Poll: Most Americans Want Congress to Prioritize Targeted Actions that Address Personal Health Care Costs; Fewer Cite Broader Reforms like Medicare-for-All and ACA Repeal as Top Priorities

    News Release

    Most Do Not Want the Supreme Court to Overturn the ACA or its Pre-Existing Conditions Protections When it comes to tackling pressing health care issues, incremental actions to address personal health care costs take precedence over broader, more partisan reforms for most Americans, according to the latest KFF Health Tracking Poll. As policymakers jockey over Medicare-for-all proposals and the legal and political fate of the Affordable Care Act, the public is more likely to choose…

  • Claims Denials and Appeals in ACA Marketplace Plans in 2023

    Issue Brief

    This brief analyzes federal transparency data released by the Centers for Medicare and Medicaid Services (CMS) on claims denials and appeals for non-group qualified health plans (QHPs) offered on HealthCare.gov in 2023. It finds that HealthCare.gov insurers denied nearly one out of every five claims (19%) submitted for in-network services. Information about the reasons for denials is limited, and few consumers appeal claims denials.

  • HealthCare.gov Insurers Denied Nearly 1 in 5 In-Network Claims in 2023, but Information About Reasons is Limited in Public Data

    News Release

    HealthCare.gov insurers denied nearly one out of every five claims (19%) submitted for in-network services and an even larger share (37%) share of claims for out-of-network services in 2023, a new KFF analysis finds. The analysis examines the main source of publicly available data on claims denials and appeals for individual-market plans available through the federal HealthCare.gov marketplace. The Affordable Care Act requires certain entities to report data about claims denials and appeals to encourage…

  • Congressional District Interactive Map: How Much Will ACA Premium Payments Rise if Enhanced Subsidies Expire?

    Issue Brief

    This analysis and interactive map illustrate how much more enrollees in Affordable Care Act (ACA) Marketplace plans would pay in premiums at the congressional district level if the enhanced subsidies were to expire in 2026 as under current law. The tool presents scenarios for an older couple who would lose subsidy eligibility due to their income level and for a single person with a $31,000 income. It also presents net average premium payment increases in…

  • 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,…

  • The Language of Health Care Reform

    Perspective

    Published in the Jan. 19 edition of JAMA, this article from KFF Executive Vice President for Health Policy Larry Levitt lays out the major health policy challenges that will confront President-elect Biden and potential approaches to major reform.While a big reform debate may not be likely this year, one is likely coming as the nation will need to confront much higher costs than in other high-income countries, worse outcomes in many cases, tens of millions…

  • Analysis Estimates 5.1 Million People Fall into the Affordable Care Act’s “Family Glitch”

    News Release

    A new KFF analysis estimates 5.1 million people nationally fall into the Affordable Care Act’s “family glitch” that occurs when a worker receives an offer of affordable employer coverage for themselves but not for their dependents, making them ineligible for financial assistance for marketplace coverage. The so-called glitch occurs because the ACA prohibits people with an offer of affordable employer coverage from purchasing subsidized coverage through the ACA marketplace. Under current rules, the affordability of…

  • Lowering the Age of Medicare Eligibility Would Likely Reduce Health Spending for Employers, But Raise Costs for the Federal Government by Covering More People in Medicare

    News Release

    Two new KFF analyses find that lowering the age of Medicare eligibility from 65 to 60 could significantly reduce health spending for employers, who could potentially pass savings to employees in the form of lower premiums or higher wages. Additionally, per person health spending for older adults who move from employer coverage on to Medicare would likely be lower, though such moves would shift costs to taxpayers and increase Medicare program expenditures overall. President Biden…