Average private health insurance premiums rose 78.4% from 2011 to 2024, and growth in healthcare spending accounted for 91% of that increase, according to a study published Sept. 4 in JAMA Health Forum.
Zack Cooper, PhD, an associate professor of health policy and economics at Yale University, conducted the study with Stuart Craig, PhD, of the University of Wisconsin–Madison. They used CMS’ Medical Loss Ratio public use files and aggregated plan-level data to the state level. The analysis covered the large-group, small-group and exchange markets. Data from self-insured employers, which cover about half of the U.S. population, was not included. The authors noted that prior research found similar premium trends for self-insured and large-group employers.
“We found that health insurance premiums increased nearly dollar-for-dollar with health spending,” Dr. Cooper said in a Sept. 18 Yale News article.
Here are five things to know from the study:
1. Mean premiums rose by $3,143 per person over the study period, from $4,008 in 2011 to $7,151 in 2024. If premiums had grown with general inflation, they would have risen 39.5%, according to the study authors.
2. Health spending rose 84.2%, or $2,844 per person. The authors describe the 91% figure as “an accounting decomposition rather than a causally identified estimate.”
3. Insurer markups, the portion of premiums that covers administrative costs and profits, rose by $299 (47.6%) in dollar terms. As a share of premiums, they fell from 18.6% to 14.9%.
4. Premium growth varied widely by state, from 10.9% in Massachusetts to 163.8% in Mississippi. In 2024, mean premiums ranged from $5,603 in Massachusetts to $11,438 in Alaska.
5. The authors concluded that efforts to slow premium growth should focus on slowing the growth of health spending. They also said future research should look at how spending relates to insurers’ administrative fees.
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