WHAT THEY ARE SAYING: LOWERING PREMIUMS MEANS ADDRESSING THE TRUE DRIVERS OF HIGHER HEALTH CARE COSTS

The following information was released by the America's Health Insurance Plans (AHIP):

by AHIP

Health plans are doing everything in their power to protect Americans from the full impact of higher costs driven by hospitals, drugmakers, and certain private equity-backed providers. Health insurance premiums directly reflect the cost of medical care and policymakers and experts are correctly pointing out that to make coverage more affordable requires addressing these rising costs:

A new CMS report shows that health care spending nationwide grew by 7.2% in 2024, reaching a record $5.3 trillion. The costs Americans paid "for hospital care, physician and clinical services, and retail prescription drugs all contributed more to overall growth," the report finds. (Health Affairs, 1/14/2026)

"'Insurance companies are dependent on what hospitals charge,' said [Sen. Rick] Scott, who was CEO of the giant hospital chain HCA Healthcare. 'I used to run the largest hospital company so I can tell you, insurance can't charge a whole bunch less if the hospitals charge more.'" (POLITICO, 1/10/2026)

"Over five years, the health expenditures in the United States for hospitals, professional services and prescription drugs have each risen nearly 40 percent or more." (Washington Post, 1/20/2026; McKinsey and Co, 1/6/2026)

"'The substantial increase in hospital [consolidation] over the past decade means that many local hospital markets that used to be relatively competitive have become concentrated over time,' [Princeton researchers] wrote in a 2025 Health Affairs article. Insurers, they concluded, 'may encounter increased challenges in controlling health care spending.'" (Washington Post, 1/20/2026)

"The cost of employer coverage, which had been going up at roughly the same pace as overall inflation, rose sharply this year and is expected to do so again in 2026...High drug prices were cited as a main factor." (New York Times, 10/22/2025)

"[Stanford Medicine expert Ola] Abdelhadi and her colleagues found in one study that 423 cancer treatment practices were acquired by 82 private equity (PE) firms between 2013 and 2022. Prices rose by a whopping 50 percent for radiation therapy at the private equity-backed firms when compared to independent oncology practices...'The ability of PE firms to extract substantial chemotherapy price increases is particularly concerning at a time when chemotherapy in the United States is becoming increasingly unaffordable,' said [Abdelhadi's] forthcoming report." (Washington Post, 12/16/2025)

"'A lot of local monopolies are driving up prices, which increases costs for everyone,' Gideon Lukens, director of research at the Center on Budget and Policy Priorities, told me. 'As you see medical debt get larger and have such a big impact on people's lives, it's a big issue.'" (Washington Post, 12/16/2025)

Common-Sense, Bipartisan Solutions to Lower Costs for Everyone

Policymakers can enact common-sense solutions to make health care more affordable for consumers. These bipartisan solutionssuch as cracking down on anticompetitive hospital mergers, implementing site-neutral payment reforms, strengthening oversight to address misuse of the No Surprises Act and curbing drugmakers' anti-competitive patent abusescan help address the market loopholes and misaligned incentives that lead to higher costs for every American.