Why are Insurance Premiums always going up with fewer benefits?

How can I explain premium increases?

It’s difficult for me to explain when people facing a premium increase, why.  For some reason, I feel it’s argumentative.   I’ll hear that they aren’t having claims, they watch their health, we should have Medicare for All.  I hope it won’t wind up as Medi-Cal for all, like some think ACA/Obamacare did, etc.  In addition, Covered CA agents are mandated to help people enroll in Medi Cal without any compensation!

Thus, I’ve compiled on this just about every resource I could find to help explain why it’s so expensive to go to a doctor, hospital or get a Rx drug.   Including a feed from CHCF California Health Care Foundation on the latest health care news and trends

Please note also, that under ACA/Obamacare and even before, Insurance Companies are mandated to spend under Medical Loss Ratio Rules a certain amount 80-85% on health care costs.  My commissions have been cut because of this, as it’s not considered health care.  Thus, I’m doing more work, for less pay.  With the internet, it does help to make it up on volume.

Options to improve affordability in CA Health Market 68 pages  June 2019

President Trump said Insurance was more complicated than anyone knew.  He should have asked me or reviewed my website!

If you have comments or questions, please post those below.  You don’t have to put in your name.

Resources & Links

  • The average cost of a hospital stay in the United States is $2,873 a day, with the average stay lasting 4.6 days, according to a recent report by Value Penguin using data from the Kaiser Family Foundation and the U.S. Agency for Healthcare Research and Quality.   Read More * 11/2022 
  • 2021 Covered CA rate increase?  Insure Me Kevin.com *
  • A $336 Band-Aid for a cut finger? Our healthcare system is nuts Los Angeles Times *
  • Obamacare rate hikes appear modest for 2020 Politico *
  • How Much Does Sex Reassignment Surgery Cost? Cost Helper.com *


Increased demand for health care.

More and more people with medical insurance are relying on the health care system as new technologies and treatments become available. This leads to a greater number of claims for payment by insurance companies, the costs of which are passed back to health care consumers.  (articles on how to be an “active consumer”) Employer-sponsored coverage  consumer demand for broad networks of hospitals and physicians and the easing of restrictions by health plans, coupled with hospital consolidation and a reduction in excess capacity, have increased the bargaining clout of some hospitals vis-à-vis health plans.

  • Breaking down the conditions raising employer health care costs March 2024 
  • “Hospital spending is back with a vengeance, and the likely causes are the retreat from tightly managed care, which has increased demand for hospital services, and rising labor costs,”
  • The hospital industry says rising costs simply show rising demand.  “The driving factor is Americans are using more hospital services.”
  • But health insurance companies say hospitals negotiating for money, not simply consumer demand, fueled the increases.
  • The biggest contributor to utilization increases is advancing medical technology new drugs, medical devices, surgical procedures, and diagnostic tests.

Milliman Waste Study

The U.S. healthcare system wastes close to three-quarters of a trillion dollars a year—and the implications are not just financial. Many of the tests, treatments, and procedures that comprise healthcare waste can expose patients to undue physical, emotional, or financial harm. VIDEO


Top 10 Wasteful Services

top 10 wasteful services

Medical Cost Trends – Behind the Numbers 2013


Rate Increase for COVID 19?

The COVID-19 outbreak could cause premiums for individuals and employers to spike from 4% to 40% next year, according to a study from Covered CA!

Treatment costs could also vary dramatically, as they could be roughly $30,000 per admission for COVID-19. That figure is based on Medicare rates and the average length of stay of 12 days, which is a similar length for other respiratory cases such as the flu or pneumonia. Fierce Health Care *

Increasing rates of chronic disease among Americans

Obesity is a major reason in determining individuals’ future rates of healthcare use Medical care prices advanced 0.3 percent last month and were 4.3 percent higher over the year. – BLS

Increase in uncompensated care.

There are an estimated 44 million Americans who don’t have health care insurance, and the cost of providing care to this group is borne indirectly by the insured consumers.
All of these increased costs flow through insurance companies and eventually trickle down to employers in the form of higher medical costs.
“The volatile combination of rising costs, increasing premiums, and a slowing economy have set the stage for consumers to pay more for care and an increase in the number of uninsured Americans,” Ginsburg said. heartland.org/
Hospital Costs Drive Medical Inflatiom upenn.edu/ The Rising Cost of Health Care

Huge and often unnecessary costs in the last 6 months of life

America’s aging population.

The “baby-boom” generation is entering its peak health-care-using period. In fact, over eighty million Americans will turn 50 in the next 10 years. The cost of providing health care to them will be staggering.

California Health Care Foundation

Blog on the latest news events

Daily News Digest

AM Best TV 
US Health Insurers Profits rise due to favorable trends
Business Wire Summary 


Pent up demand when ACA started
Government Programs Medi Cal

Misc. Links & Resources

  • What does inflation mean for health care?





    Health insurers hike ACA premiums, but not due to possible subsidy losses

    Bureaucracy no cure for rising healthcare costs



    An early look at what is driving health costs in 2023 ACA markets







  • https://www.fiercehealthcare.com/payers/report-these-are-factors-impacting-individual-small-group-premiums-2023






  • Covered CA announces average 4% rate increase for 2015.
  • Rates might have double digit increases in 2015 – Interview with Joe Swedish of Blue Cross – Modern Health Care 4.17.2014
  • Health Affairs.org

See our historical page for many items prior to 2014 – the best are still on this, our main page.

Cost of developing new technologies and treatments.

Over the past decade, scientists have made significant advancements in the treatment of certain diseases. Unfortunately, just like any new product, the cost of developing these new technologies and treatments is extremely high. Plus, unlike other technology, health technology generally doesn’t decrease in price over time. How Changes in Medical Technology Affect Health Care Costs KFF.org

3 comments on “Premium increases? Why are they always going up?

  1. Whatever happened to grandfathered rates & premiums our our policy. Seems that every time the policy renews it’s a lesser coverage?

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