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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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  • Short-Term Health Insurance Plans Charge Less than Half as Much in Premiums as ACA Plans By Excluding Pre-Existing Conditions and Severely Limiting Benefits

    News Release

    Short-term health insurance plans offer a trade-off for consumers: substantially lower premiums than plans that comply with the Affordable Care Act, but much less protection if they get sick and need care. Just how much cheaper are the premiums and what are consumers giving up to get them? A new KFF (Kaiser Family Foundation) analysis finds short-term plans are able to charge premiums 54 percent lower than ACA-compliant plans, by excluding pre-existing conditions and severely…

  • Private Insurers Are Expected to Pay a Record of At least $1.3 Billion in Rebates to Consumers Beginning in September for Excessive Premiums Relative to Health Care Expenses

    News Release

    Private insurance companies are expecting to pay out a record of at least $1.3 billion in rebates to consumers this fall based on their share of premium revenues devoted to health care expenses in recent years, surpassing the previous record high of $1.1 billion in 2012, according to a new KFF analysis. Individual market insurers are driving this record year, with expected rebate payments of at least $743.3 million, their highest ever, finds the analysis…

  • Poll: Most Democrats Prefer a Presidential Candidate Who Wants to Build on the Affordable Care Act

    News Release

    The latest KFF Health Tracking Poll probes Democrats’ views about the general approaches to expanding health coverage and lowering costs put forward by the candidates. Most Democrats and Democratic-leaning independents (55%) say they prefer a candidate who would build on the Affordable Care Act to achieve those goals. Fewer (40%) prefer a candidate who would replace the ACA with a Medicare-for-all plan. Even among those who prefer a candidate who would replace the ACA with…

  • Pulling it Together: Last Week’s Health Reform “Shocker”

    Perspective

    Last week we learned that health reform could cost the federal government at least a trillion dollars over ten years, and that it will be really difficult to forge bipartisan agreement on legislation and keep major interest groups on board. This obviously brought more angst to the deliberations, several Republicans seized the moment to criticize the Democrats' plans, and the press was all over it, with many commentators declaring health reform in dire straits. But…

  • Health Care Costs Survey – Toplines

    Poll Finding

    This document includes the toplines from the joint USA Today/Kaiser/Harvard School of Public Health survey exploring Americans’ views on health care costs. Survey Toplines (.pdf)

  • Uniform Coverage Summaries for Consumers

    Issue Brief

    This brief explains the proposed federal rule that requires private health plans to provide a short, easy-to-read uniform summary of benefits and coverage to all health insurance applicants and enrollees. The rule, which implements a provision in the Affordable Care Act (ACA), is intended to make it simpler for consumers to compare health plans before they enroll and understand their coverage once they are enrolled. Currently, consumers in employer-sponsored plans receive summaries of their benefits,…

  • Analysis: Cost of Treating Opioid Addiction Rose Rapidly for Large Employers as the Number of Prescriptions Has Declined

    News Release

    A new Kaiser Family Foundation analysis finds that while the use of prescription opioids among people with employer-based health coverage has declined to its lowest levels in over a decade, the cost of treating addiction and overdoses has increased sharply. The annual cost of treating opioid addiction and overdose – stemming from both prescription and illicit use -- has increased by more than eight-fold since 2004, from $0.3 billion dollars to $2.6 billion in 2016.…

  • Proposals for Insurance Options That Don’t Comply with ACA Rules: Trade-offs In Cost and Regulation

    Issue Brief

    This brief examines four options to promote the sale of health plan options in the individual or non-group market that are not subject to Affordable Care Act (ACA) requirements for other major medical health plans. It reviews the trade-offs involved if such loosely regulated markets take root as an alternative to the ACA-regulated market, particularly as the repeal of the individual mandate penalty takes effect next year.

  • Brief Examines Efforts to Create Health Plan Options that Don’t Comply with the Affordable Care Act’s Rules

    News Release

    Though Congress last year failed to repeal key Affordable Care Act requirements for non-group health insurance that people buy themselves, the Trump Administration and some states are promoting other types of plans through regulatory changes that would allow the sale of products that skirt many of the ACA’s requirements. A new Kaiser Family Foundation brief examines four of those options and the tradeoffs involved if such loosely regulated markets take root as an alternative to…