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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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  • Federal Government Could See Net Increase of $2.3 Billion in Costs in 2018 if ACA Cost-Sharing Reduction Payments Eliminated

    News Release

    Ceasing payments for the Affordable Care Act’s (ACA) cost-sharing reduction program could save $10 billion, but cost an additional $12.3 billion in premium tax credits – an estimated net increase of $2.3 billion, or 23 percent, in federal spending on marketplace subsidies – in 2018, if insurers continue to participate in ACA marketplaces, according to a new analysis from the Kaiser Family Foundation. The cost-sharing subsidies, established to reduce out-of-pocket costs for ACA marketplace enrollees…

  • Poll: Majority Opposes Hard-Ball Negotiating Tactics to Replace the Affordable Care Act, But Republicans Support It

    News Release

    Somewhat More Want President Trump and Republicans to Continue Working on ACA Repeal and Replace than Want Them to Move onto Other Priorities With President Trump and Congress continuing to discuss repealing and replacing the Affordable Care Act, a majority of the public opposes using hard-ball tactics as a way to force Democrats in Congress to negotiate a replacement, the latest Kaiser Health Tracking Poll finds. President Trump recently suggested that his administration and Congress…

  • Analysis: 6.3 Million People with Pre-Existing Conditions Would Be at Risk for Higher Premiums under the House’s Health Bill

    News Release

    A new Kaiser Family Foundation analysis estimates that 6.3 million people -- 23 percent of 27.4 million non-elderly adults with a gap of several months in insurance coverage in 2015 – could potentially face higher premiums under the House’s American Health Care Act (AHCA), due to pre-existing health conditions. The bill, which passed the House earlier this month, allows states to waive community rating in the individual insurance market. Insurers in states with such waivers…

  • What Do We Know About People with High Out-of-Pocket Spending?

    Feature

    Based on an analysis of claims data, this slideshow examines overall trends, gender and age of high out-of-pocket spenders in large employer health plans, as well as differences in out-of-pocket health expenditures across diseases.

  • New Analysis Finds High Out-of-Pocket Spending Increased for People Covered by Large Employer Plans

    News Release

      A new Kaiser Family Foundation analysis finds about one in four people (24%) covered by large employer plans spent more than $1,000 out-of-pocket on health care in 2015, an increase of seven percentage points from 17 percent in 2005. About 1 in 10 people in such plans (12%) paid more than $2,000 out-of-pocket in 2015, a distribution that mirrors the distribution of overall health spending, according to the new analysis of claims data. Dollar…

  • Sizing Up Exchange Market Competition

    Issue Brief

    This issue brief offers an early look into how competitive the health insurance exchanges (also called marketplaces) are under the Affordable Care Act in selected states. Through analysis of enrollment data released by seven states (California, Connecticut, Minnesota, New York, Nevada, Rhode Island, and Washington) this brief finds that exchange markets in California and New York are shaping up to be more competitive than their individual markets were in 2012 while those of Connecticut and…

  • California’s Uninsured on the Eve of ACA Open Enrollment

    Report

    This report presents the findings of a baseline survey of California’s uninsured adult population just before the start of the first open enrollment period under the Affordable Care Act (ACA). It will be followed by three other surveys over the course of the next two years that will capture the changing experiences and attitudes of this same group of 2,000 people over time, whether they obtain coverage or remain uninsured. The report analyzes the uninsured…

  • Obamacare y Usted: Si compra seguro médico en el mercado individual

    Fact Sheet

    Si usted compra su plan de salud por su cuenta (en vez de tener cobertura a través de su empleador), usted tendrá nuevas opciones para tener su cobertura, pero la Ley del Cuidado de Salud a Bajo Precio requiere que usted esté asegurado o será multado. Qué está cubierto Bajo Obamacare, los planes de salud deben cubrir visitas al doctor, hospitalizaciones, recetas de drogas y cuidado materno sin restricciones por condiciones preexistentes, o condiciones físicas…