Private Insurance

New and Noteworthy

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

Survey

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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How Narrow or Broad Are ACA Marketplace Physician Networks?

Aug 26, 2024
Report

This report examines the share of doctors participating in the provider networks of Qualified Health Plans (QHPs) offered in the individual market in the federal and state Marketplaces in 2021, and how network breadth affected costs for enrollees.
KFF Analysis Finds Physician Networks in ACA Marketplace Plans Vary Widely, and Enrollees Typically Pay More in Premiums to Access Broader Networks

Aug 26, 2024
News Release

A KFF analysis of physician networks in the Affordable Care Act’s Marketplace plans finds wide variations in the share of local practicing physicians who participate, with the least costly plans generally having a smaller share of physicians than more expensive plans.
While Medicare Drug Price Negotiations Don’t Apply to Private Insurance, 3.4 Million People with Employer Coverage Take at Least One of the Selected Drugs

Aug 14, 2024
News Release

Among the 167 million people with employer-sponsored insurance in 2022, 3.4 million used at least one of the first 10 drugs identified for Medicare price negotiations.
Compare the Candidates on Health Care Policy

Aug 5, 2024
Feature

The side-by-side comparison tool provides a quick overview of former President Trump's and Vice President Harris' records, positions, public statements, and proposed policies on a range of key health care topics.
Marketplace Insurers are Proposing a 7% Average Premium Hike for 2025 and Pointing to Rising Hospital Prices and GLP-1 Drugs as Key Drivers of Costs

Aug 5, 2024
News Release

ACA Marketplace insurers are proposing a median premium increase of 7% for 2025, similar to the 6% premium increase filed for 2024, according to a new KFF analysis of the preliminary rate filings. Insurers’ proposed rate changes – most of which fall between 2% and 10% – may change during the review process.
How Much and Why ACA Marketplace Premiums Are Going Up in 2025

Aug 5, 2024
Issue Brief

This analysis of insurers' preliminary rate filings shows that ACA Marketplace insurers are requesting a median premium increase of 7% for 2025, similar to the 6% premium increase filed for 2024. Insurers cite growing health care prices – particularly for hospital care – as a key driver of premium growth in 2025.
Inflation Reduction Act Health Insurance Subsidies: What is Their Impact and What Would Happen if They Expire?

Jul 26, 2024
Issue Brief

Enhanced premium subsidies were first made available under the American Rescue Plan Act and extended until the end of 2025 under the Inflation Reduction Act. This analysis shows the impact that enhanced subsidies have had on enrollment and premium payments, and the potential implications if the enhanced subsidies expire.
ACA Marketplace Enrollees Will See Steep Increases in Premium Payments in 2026 if Enhanced Subsidies Expire

Jul 26, 2024
News Release

Without the enhanced subsidies in the Inflation Reduction Act (IRA), Affordable Care Act (ACA) Marketplace enrollees in 12 of the states that use HealthCare.gov would see their annual premium payments at least double on average, according to a new KFF analysis.
Health Insurer Financial Performance in 2023

Jul 2, 2024
Issue Brief

Using health insurer financial data for 2023, we find that in 2023, per enrollee gross margins were highest in the Medicare Advantage market, and medical loss ratios were lowest in the individual insurance market. Across most markets, gross margins have been relatively stable in recent years.
Supreme Court Decision Limiting the Authority of Federal Agencies Could Have Far-Reaching Impacts for Health Policy

Jul 1, 2024
Issue Brief

On June 28, 2024, the U.S. Supreme Court overturned a longstanding legal precedent that required federal courts to defer to reasonable agency interpretation when statutes are ambiguous. The decision will shift many policy decisions from federal agencies to federal judges, with implications for health policy that will reverberate for years to come. This issue brief examines the decision and assesses what’s ahead.