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The big picture: Why health care costs so much

Next year is going to be another year of big ACA premium increases — but this time Republicans won't be able to pin all the rate hikes on Democrats.

Data: Kaiser Family Foundation; Cartogram: Kerrie Vila and Chris Canipe/Axios
  • These are the first rate hikes since Congress got rid of the individual mandate penalty. It was the most unpopular part of the ACA, but it was there to make sure healthy people bought coverage.
  • Without the healthy people, there are probably going to be more premium increases since insurers can't count on them to balance the costs of sick people.
  • The rate hikes for next year are mostly in double digits so far.
  • That's not the only reason rates are going up. There's also the prices doctors and hospitals are charging for their services, and the rising cost of prescription drugs.
  • In Maryland, Kaiser Permanente says it's raising premiums by an average of 37% for next year for lots of reasons. But the end of the mandate is "expected to have a significant impact, driving a large reduction in membership," according to the company's rate filing.

The big picture: These rate increases aren't hitting everyone in the country. It's just the 7% of Americans who get their health insurance through the ACA.

  • The takeaway: Health care is getting more expensive for all of us — as health care spending and premiums have been growing faster than household incomes for the past decade.

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