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Healthcare spending in the United States reached nearly $5.3 trillion in 2024, up from $3 trillion a decade earlier, according to federal data. The burden no longer falls only on people without insurance. Families with steady jobs and coverage now say the bills are reshaping their daily choices.
KFF Health News reporters heard from more than 130 people this year who struggle with premiums, copayments, prescriptions and hospital bills. Many are skipping visits, rationing medication or dropping coverage. Meanwhile, housing, energy and food costs keep rising too.
Healthcare costs reach insured households
Sheila Robinson, 61, of District Heights, carries a $10,000 deductible on her Affordable Care Act plan. She charges her $659 monthly premium to a credit card and negotiates self pay prices at the doctor’s office. As a result, she now fears going to appointments.
Janet Marx, 56, of Milford, Connecticut, has coverage through Medicare and her husband’s employer. Even so, the couple sold her childhood home to pay for care tied to lupus and fibromyalgia.
The typical American family spends about $5,600 a year, or 9% of income, on premiums, out of pocket care and health taxes, according to a health system tracker from Peterson and KFF.
Why healthcare prices keep climbing
Experts point to several causes. Hospitals are merging and using their market power to charge more. New treatments, including GLP-1 drugs for weight loss and diabetes, carry high price tags. Tariffs and inflation add costs to supplies such as gloves and medical devices. Also, a growing number of uninsured Americans leaves fewer people to share the load.
Christopher Whaley, a health policy researcher at Brown University, says all of these forces are hitting at once. He also notes that the fee for service model pays hospitals and doctors for every test and procedure, so they earn more when they bill more.
Prescription drug prices fell by the largest margin in decades this year. Still, many households say they have not felt relief.
What comes next for healthcare affordability
Insurers expect ACA marketplace premiums to rise 15% next year, the second straight double digit increase. Employer health costs will likely rise 9.5% as well, which will push more of the burden onto workers. In addition, the Congressional Budget Office projects the uninsured population will grow by 10 million or more by 2034. About 27 million people lacked coverage in 2024.
Relief will not come easily. Lower costs for patients mean lower pay for hospitals, drugmakers, insurers and doctors. The health sector has spent more than $14 billion lobbying Congress since 1998, according to OpenSecrets. As a result, many proposals shift who pays instead of cutting what care costs.
For now, families are adjusting on their own. Lynn Ludaway of Evanston, Illinois, pays a $500 monthly premium after a multiple sclerosis diagnosis, yet her household earns too much for aid. She skips dental and mental healthcare to stay afloat.
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