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BTD Health Policy in 2026

Health Policy in 2026

In a new column, 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

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.

Explaining Individual Coverage Health Reimbursement Arrangements (ICHRAs)

Examining Short-Term Limited-Duration Health Plans

Health Savings Account Provisions in the 2025 Tax and Spending Law

Consumer Experiences with Health Insurance

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  • 2022 Health Insurance Marketplace Calculator

    Interactive

    The Health Insurance Marketplace Calculator, updated with 2022 premium data, provides estimates of health insurance premiums and subsidies for people purchasing insurance on their own in health insurance exchanges (or “Marketplaces”) created by the Affordable Care Act (ACA).

  • Outpatient Visits Are Growing More Complex: Implications for Health Costs

    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

    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.

  • How are Large Private Insurers Covering At-Home Rapid Tests?

    News Release

    Less than a week after a new federal mandate to cover such products took effect, about half of the nation’s largest private insurers allow enrollees to directly obtain rapid at-home COVID-19 tests from specific sources without having to pay anything upfront, a new KFF analysis finds. The new coverage requirement took effect Jan.

  • Network Adequacy Standards and Enforcement

    Issue Brief

    Health plan networks affect patient access to care. This brief reviews options for setting and enforcing network adequacy standards and tools for making differences in plan networks more transparent.

  • High-Risk Pools For Uninsurable Individuals

    Issue Brief

    For more than 35 years, many states operated high-risk pool programs to offer non-group health coverage to uninsurable residents. The federal government also operated a temporary high-risk pool program established under the Affordable Care Act (ACA) to provide coverage to people with pre-existing conditions in advance of when broader insurance market changes took effect in 2014. This issue brief reviews the history of these programs to provide context for some of the potential benefits and challenges of a high-risk pool.

  • How ACA Marketplace Premiums Measure Up to Expectations

    Perspective

    Premium increases in the health insurance marketplaces created under the Affordable Care Act (ACA) will likely be higher in 2017 than in recent years; however, the actual average benchmark premium in the ACA marketplaces in 2016 is below what the Congressional Budget Office projected for 2016 before the health law was passed. How actual marketplace premiums compare to what CBO expected in doing those budget projections is an important factor in determining whether the ACA continues to be on track to reducing the deficit.