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, ask why.  For some reason, I feel it’s argumentative.   I’ll hear that they aren’t having claims, they watch their health don’t have any pre X, etc.

• The 25% Problem:  (We don’t need 25% of the services) Why Health Care Is So Expensive (And What We Can Do About It)  CHCF 10/2025 
• Co Pays and Deductibles or not???     LA Times 1.8.2025 *
• Breaking down the conditions raising employer health care costs  UHC 10/2024
• California Office of Health Care Affordability (OHCA)  visit their website *
• Medical inflation vs the rest of the economy Kff.org *
• 2024 Failing US Health System comparing to 10 other countries  Commonwealth Fund *
• Shining a Light on Health Insurance Rate Increases CMS.Gov

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.

• 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

• A $336 Band-Aid for a cut finger? Our healthcare system is nuts ^{Los Angeles Times} *
• How Much Does Sex Reassignment Surgery Cost? ^{Cost Helper.com} *
• California Health Care Almanac Spending   pdf 
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  • Facebook.com  Discussion of paying your own bills or not…???
  • Survey data shows stress spreading beyond medical bills  hcamag.com 1/2026
  • In 2026, Affordable Care Act (ACA) premiums increased by more than 20 percent, in large part because insurers believe they are facing increased risk due to the expiration of enhanced premium tax credits and other policies.  Read more  Commonwealth Fund.org 1/2026  
  • Health Insurers, Lawmakers Lock Horns Over High Cost Of Medical Care  KFF.org  1/2026  

HMO Act of 1973

• Cost Control Strategy: The act was designed as a proactive strategy to combat medical inflation by providing a prepaid, cost-effective alternative to traditional insurance.
• Preventative Focus: Supporters aimed to incentivize “health maintenance” rather than just sick care, theoretically providing better, more efficient service.
• Mandated Dual Choice: Section 1310 required employers with 25 or more employees to offer a federally certified HMO option if they already offered traditional health insurance.
• Corporate Expansion: It allowed for-profit entities to run HMOs and offered federal backing for their development. [1, 2, 5, 6, 7]

• The Ehrlichman Tape: A known 1971 conversation between President Nixon and his domestic policy advisor, John Ehrlichman, reveals an understanding that HMO incentives differed from traditional care.
• Incentive Structure: Ehrlichman explicitly told Nixon: “All the incentives are toward less medical care, because the less care they give them, the more money they make”.
• Strategic Choice: While proponents believed in the preventative benefits, the Nixon administration embraced the model specifically to cut costs, acknowledging that the profit-driven structure might result in lower utilization of services. [1, 8, 9, 10, 11]