Health care costs are surging. ACA Marketplace premiums will rise 18% next year— even more for the millions set to lose their enhanced federal subsidies without congressional action. Meanwhile, big employers expect their premiums — already about $25,000 for family coverage — to increase 9% in 2026. Gargantuan health care profits are the flip side of those unsustainable cost increases.

Already, the average American lays out more than $17,000 for health care, a figure that includes the insurance premiums they and their employers pay as well as copayments, deductibles, and the taxes that fund Medicare, Medicaid, and other public programs. Where five decades ago, U.S. health costs were middle-of-the- pack among wealthy nations, today Americans spend about 50% more on health care than the

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