By Mark Merritt, Executive Director, Insurance Watchdog Coalition
The MAHA Summit should tackle one of health care’s toughest challenges: reining in insurance costs so patients can afford the care they need.
Insurance costs are rising far faster than the cost of underlying medical care.¹ Yet insurers often point to hospitals, doctors, drug companies and others when explaining why Americans keep paying more.
But insurer practices are part of the affordability problem too.
SHOULD HEALTH INSURANCE COST MORE THAN YOUR MORTGAGE?
The average family health plan now costs more each month than the median mortgage payment on a newly purchased home.²
Meanwhile, America’s largest health insurers generate billions of dollars in profits.³
That’s unsustainable.
| HOW INSURERS DRIVE UP HEALTH CARE COSTS: OVERCHARGING EMPLOYERS MEDICARE UPCODING HIDDEN PBM FEES STEERING PATIENTS TO EXPENSIVE SUBSIDIARIES GENERIC DRUG MARKUPS |
INSURERS SHOULD ANSWER FOR THEIR OWN COSTS
Today’s largest insurers increasingly own physician groups, pharmacies, PBMs and other businesses that receive health care dollars.
That raises an important question: Are insurers lowering costs — or steering more health care dollars through businesses they own?
Insurer practices deserve scrutiny too. Medicare pays more when insurers make patients look sicker than they are, while billions counted toward insurers’ medical spending requirements never pay a medical or prescription-drug claim.⁴
Those are just two examples of why insurers themselves belong at the center of the affordability debate.
AFFORDABILITY REQUIRES INSURER ACCOUNTABILITY
MAHA is right to focus on making Americans healthier. Reining in insurance costs should be job one.
Insurers often blame hospitals, doctors, drug companies and others for rising health care costs. Their own practices deserve scrutiny too.
Where is the money going? Why are insurance costs rising? And what are insurers doing to bring them down?
Those are questions worth asking as America looks for ways to make health care more affordable.
It’s tough to stay healthy when you can’t afford insurance.
¹ KFF, 2025 Employer Health Benefits Survey; BLS medical-care CPI and Altarum Health Sector Economic Indicators.
² KFF, 2025 Employer Health Benefits Survey; Mortgage Bankers Association, Purchase Applications Payment Index, August 2026.
³ Insurance Watchdog Coalition, insurer profitability analyses and research library.
⁴ Insurance Watchdog Coalition, The Medicare Advantage Spending Gap (September 2026); MedPAC and Committee for a Responsible Federal Budget analyses of Medicare Advantage coding and overpayments.
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Insurance Watchdog Coalition’s mission is to educate legislators, regulators, key opinion leaders, the media and the American people about the harmful impacts of vertically integrated insurance monopolies, especially in our healthcare system, which in turn will help create more competition in the marketplace, lower healthcare costs, and ensure that healthcare savings go to patients, not big insurers.