It’s open enrollment season. And for the 20 million Americans who buy their own health insurance, prices are through the roof.

Rates are up an average of 30 percent for a typical plan in the 30 states where the federal government manages markets. In states that run their own markets, rates are up an average of 17 percent. That’s according to an analysis from the health policy research group KFF.

Meanwhile, the longest government shutdown continues in Washington. Lawmakers still can’t agree over whether to extend subsidies that would make health insurance more affordable. Without those subsidies, experts estimate that more than 4 million people could lose access to insurance.

How did health insurance get so expensive in the first place? And who stands to benefit from higher costs?

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