NEW: Families USA on Why Health Care Premiums Keep Going Up and How Congress Address Health Care Affordability Crisis - Families USA Skip to Main Content
11.18.2025 / Press Release

NEW: Families USA on Why Health Care Premiums Keep Going Up and How Congress Address Health Care Affordability Crisis

WASHINGTON, D.C. – With the fight to extend enhanced premium tax credits bringing health care affordability front and center in Washington, Families USA today released a new analysis of this year’s health insurance premium rate filings, detailing and summarizing the drivers of why premiums are rising. Health insurance rates are, on average, at least 25% higher next year than in 2025 — before taking into consideration the impact of the expiring tax credits, which will cause consumers to face premiums increases of over 100%, on average.

The analysis explains the upcoming increases of the base rate in insurance companies’ own words, reviewing the 2026 insurance rate filings to understand the key drivers of high and rising premiums for people seeking to enroll in the ACA’s individual and small-group health insurance coverage for plan year 2026. The top drivers of premium rates were:

  • High hospital and provider prices driven by health care consolidation.
  • Rising prescription drug costs.
  • Increased utilization of certain services and growing administrative costs, and
  • The expectation of covering a smaller and sicker risk pool due to the expiration of enhanced premium tax credits in the ACA marketplaces.

“Extending the ACA tax credits to prevent massive premium spikes should be the easy vote for Congress, and an entry point to address health care affordability broadly. Americans, regardless of their party or whether they get coverage through the marketplaces or their employer, are sick and tired of paying too much for care,” said Anthony Wright, executive director of Families USA. “The health insurance rate filings provide a roadmap for advancing an actual affordability agenda on health care costs, to follow the money and take on the drivers of increased costs, whether from prescription drug companies, insurers, big hospital systems, or other parts of the industry. Extending the tax credits is an explicit factor in these premium spikes, but there’s more that Congress can and must do to confront health care costs.”

Families USA has long been on the frontlines of the fight to rein in corporate greed in the health care system and address the nation’s health care affordability crisis. Earlier this year, polling revealed that an overwhelming majority of American voters on both sides of the aisle want Congress and the administration to take action to lower the cost of health care, including solutions Families USA has long advocated for that directly tackle corporate health systems overbilling and price gouging.

In the new analysis, Families USA calls on Congress to take immediate action not just on extending the enhanced premium tax credits, but also a range of policy proposals that are pending in Congress, including many that are vetted with bipartisan support:

  • Stopping corporate health systems from charging Medicare more for the same procedures if performed at a hospital facility instead of a doctor’s office.
  • Requiring all hospitals and health plans to disclose the prices they charge in dollars and cents in a clear format.
  • Closing legal loopholes that allow drug companies to raise prices by ending patent abuses.
  • Restricting predatory billing practices by providers that increase health care costs.
  • Prohibiting Medicare Advantage companies from exaggerating patients’ health risks to get paid more by the federal government.
  • Reforming the way doctors and providers are paid so pay is based on keeping people healthy and providing quality care rather than performing a larger number of procedures.