Rising premiums and shrinking doctor pay spark debate over Obamacare's winners
Sixteen years after the Affordable Care Act, premiums have nearly doubled while Medicare physician payments have fallen, prompting calls for a full economic audit of the system.
A decade and a half after the Affordable Care Act reshaped U.S. health coverage, the financial picture shows stark contrasts. Family health insurance premiums offered by employers rose from $13,770 in 2010 to $26,993 in 2025, while deductibles and other out-of-pocket costs also climbed, leaving many insured yet underinsured. At the same time, Medicare’s inflation-adjusted payments to physicians fell 33% from 2001 through 2026, and doctors now spend roughly 12 hours weekly on prior authorizations, averaging 43 requests.
Large health conglomerates, exemplified by UnitedHealth Group, expanded revenue nearly fivefold—from $94.2 billion in 2010 to $447.6 billion in 2025—and broadened into insurance, pharmacy benefits, data analytics, and direct care. The piece calls for Congress to commission a comprehensive audit tracking federal health funds through insurers, PBMs, corporations, and providers to determine who captures the surplus. It stresses that policy should be judged by outcomes: whether rising costs primarily reward administrative complexity or genuine patient care.
Why it matters
Understanding who profits from rising health costs is essential for evaluating the Affordable Care Act's long-term impact.
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