Your health insurance rates are going to rise next year: Here's why

by Ellyn Vohnoutka

edited by Gaby Clark, reviewed by Andrew Zinin

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Employer health care costs are on track to climb about 11% next year, the sharpest jump in more than two decades.

Companies expect to hold that increase closer to 8% by scaling back what their health plans cover. Even the smaller figure would be the steepest rise since 2003, reports The New York Times.

The projection comes from a survey of 1,800 employers by Marsh, a benefits consulting firm. Results were released Wednesday.

More than a third of those employers said they expect their costs to rise at least 10% even after they trim benefits.

"This year was a rough year, and next year looks like it will be even rougher," Beth Umland, Marsh's director of employer research for health and benefits, told The Times.

About 160 million Americans under age 65 get health insurance through a job, The Times reported. Many of them will pay more next year in premiums, deductibles and copays.

Employers are trimming coverage in other ways, too.

Some have stopped paying for GLP-1 drugs used to treat obesity. Others have dropped coverage for spouses who can get insurance somewhere else.

Employers and benefits consultants pointed to several forces behind the jump.

Hospitals are charging more. So are drugmakers, especially for cancer medicines. Demand is also high for GLP-1 drugs prescribed for conditions like type 2 diabetes.

Two newer factors stand out.

Hospitals and doctors are using artificial intelligence to document patient care in far more detail, which can raise the amount insurers pay them.

Additionally, some out-of-network doctors are using a new consumer protection law to challenge their payments and win larger ones, according to The Times.

Looming cuts to Medicaid could add still more pressure.

Medicaid is the government program that covers health care for people with low incomes. Hospitals are already treating more patients who have no insurance or cannot pay their bills. To recover that lost money, many are expected to charge employers more.

Some employers are rethinking how they buy health care altogether.

Miami-Dade County Public Schools covers roughly 45,000 employees and their families. Hospital care eats up most of its health spending, but pharmacy bills are climbing the fastest.

"It's become really, really difficult, extremely difficult," Rosa Novo, the district's benefits administrator, told The Times.

The school system is now weighing whether to contract directly with hospitals and doctors for services such as imaging, rather than letting its insurer negotiate those prices. It is also demanding audits and detailed records of what it pays for.

"We're having to reinvent the way we operate," Novo said.

Key medical concepts

Glucagon-Like Peptide-1 Receptor AgonistsObesityDiabetes Type 2Antineoplastic Agents Who's behind this story?

Gaby Clark

MA in English, copy editor since 2021 with experience in higher education and health content. Dedicated to trustworthy science news. Full profile →

Andrew Zinin

Master's in physics with research experience. Long-time science news enthusiast. Plays key role in Science X's editorial success. Full profile →

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