Many people in the United States are struggling to pay for their health insurance. High premiums limit access to coverage. But what’s actually fueling the increase?

Health insurance premiums rose nearly 80% between 2011 and 2024. News flash: Insurers didn’t create the increase, hospitals did. 

Healthcare spending – meaning what hospitals and providers are charging patients–accounted for 91% of the increase in premiums during this period.

These staggering findings were published by scholars at Yale and the University of Wisconsin-Madison. The study, published Sept. 4 in JAMA, reveals that the rising prices hospitals are charging patients is what’s driving the healthcare unaffordability crisis. 

Additional research from The Healthcare Affordability Lab at Yale confirms health insurers’ markups have actually gone down. Between 2011 and 2024, insurers’ markups decreased from nearly 19% to less than 15%. This underscores the fact that medical spending is driving the increase in premiums, not a higher percentage of markups. 

For families, what healthcare providers charge ultimately shows up in what they pay for insurance. For employers, rising premiums can mean more money spent on health benefits instead of wages and other investments.

When health insurance gets more expensive for employers, workers feel it too. Rising premiums can mean smaller raises, fewer jobs and a wider income gap. This compounds the current cost of living problems Americans are facing. 

For policymakers looking to make coverage more affordable, the data suggests that focusing on insurance premiums alone misses the primary source of the problem.

The solution? The researchers say lowering the underlying cost of healthcare spending must be part of the solution.

“Given the high burden insurance premiums are placing on the US public, understanding the mechanisms behind insurance premium growth is critical to being able to introduce policies that can successfully slow the growth in premiums,” the researchers wrote in the study. 

What are hospitals and other healthcare providers charging you for care? Share your latest healthcare bill with us.                                                                          

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