January is our health care issue, and it’s also the end of the year, which means our advertisers are planning their budgets for the coming year. That typically results in a leaner newspaper. So I am only going to touch on the subject of health care costs — a huge topic.
U.S. health spending has grown steadily in recent years and continues to outpace economic growth. In 2023, according to the American Medical Association, total national health expenditures reached about $4.9 trillion, accounting for roughly 17.6% of gross domestic product. Spending increased 7.5% from the previous year — the largest growth rate outside the early COVID-19 pandemic period. The AMA reported that personal health care consumption — including hospital, physician and prescription drug services — accounted for 84.4% of total spending.
Higher costs have hit close to home. The insurance premium for John and me in 2026 will be just under $2,000 and that is with a high deductible plan from Kaiser Permanente. Our editor, Marylou Bride, was facing co-pays for daily osteoporosis shots totaling $1,000 a month. Fortunately, she found another option — generic shots twice a year for $500. Still, it’s not a cheap shot for many but it’s a “cheap shot” for health care.
Rising costs can be attributed to a number of factors, including higher utilization of medical services, expensive prescription drugs, labor and inflation pressures, and the structure of the U.S. health system, which lacks price regulation, according to the Physician Leadership Association.
In the United States, the cost of health insurance is based on the type of coverage, age and location. For employer-sponsored plans in 2025, the average annual premium for single coverage is about $9,325 — roughly $777 per month — while family coverage averages nearly $26,993 per year, according to KFF (formerly the Kaiser Family Foundation).
The Washington Post cited a recent Gallup survey showing that nearly one in four Americans say the U.S. health care system is in crisis, with high costs cited as the leading concern. Many respondents reported postponing care because of the expense, a trend that can worsen health outcomes and ultimately increase overall health care costs.
If the Affordable Care Act’s enhanced subsidies are not extended, millions of Americans who buy insurance through ACA marketplaces could face much higher premiums or even lose coverage. The enhanced premium tax credits — expanded during the COVID-19 pandemic and later extended by Congress — are set to expire at the end of 2025 unless lawmakers act. According to KFF, enrollees would be responsible for a larger share of their costs, and average premiums for marketplace plans are projected to more than double in 2026 for many people.
Higher costs could lead to fewer people buying insurance, particularly healthier individuals who may drop coverage first. That trend typically raises premiums for everyone remaining in the market and can destabilize the risk pool.
According to a Dec. 21 Time article, the most immediate consequence of failing to extend the ACA enhancements would be higher consumer costs and a likely increase in the uninsured rate next year.
A KFF poll found that just under half of U.S. adults reported difficulty affording health care, and about three in 10 had trouble paying for care in the past year. This strain was notable even among insured individuals, underscoring that coverage does not guarantee affordability.
As Americans struggle to navigate an increasingly expensive health care system, Congress appears to be doing nothing. Meanwhile, members of Congress continue to enjoy guaranteed access to lower-cost health insurance.
Happy New Year!
See you in February!
Michelle
