The Coming Crisis in Health Care and the Crisis We Already Have

[Celerity]

https://prospect.org/health/2025-09-11-coming-crisis-in-health-care-and-crisis-we-already-have/



A health care crisis is coming. It may be here as soon as this winter. Analysts estimate that employers will be facing average health insurance premium increases next year of 9 percent, the largest in 15 years. Unions are reporting employers are coming to the bargaining table now saying they are facing much greater increases—over 20 percent. And patients in the individual market will see a median increase of 18 percent, even before the expiration of Affordable Care Act exchange subsidies that would spike out-of-pocket costs for those affected by over 75 percent.

This crisis seems clearly to have been triggered by President Trump’s reconciliation legislation, even though most of its health care provisions won’t go into effect until 2027. Democrats are considering whether they will demand patches and fixes to prevent an insurance premium spike as part of negotiations over government funding. But they also need to reckon with some very inconvenient truths.

First, Trump is likely not to repeal the Affordable Care Act, but to break it. His aim since the failure of repeal in 2017 has been to defund critical pillars to make the entire complex edifice, designed to expand coverage while making both hospitals and insurance companies happy, collapse. Second, it may not be possible to put Humpty Dumpty back together again. It seems unlikely that Medicaid funding in particular can be restored before significant structural damage is done to the existing system: to rural hospitals, to employer health coverage, and to a variety of other structural features of the current system.

Third, trying to put Humpty Dumpty back together again is political suicide. The current system is deeply unpopular. Witness the level of popular support for Luigi Mangione, killer of the CEO of UnitedHealthcare, the company that more than any other one embodies the current system. According to Emerson College polling, 41 percent of those under 30 found the murder acceptable, and a University of Chicago poll found that more than two-thirds of all adults polled thought that health insurance company practices were in part responsible. Fourth, the current system is an economic ball and chain around the ankles of U.S. society. It costs four times what the most cost-effective health systems in the developed world cost, burdening individuals and businesses.



snip

[erronis]

1. An excellent piece in The American Prospect. Thanks for posting!

[Celerity]

2. yw