The U.S. health care system is massive. It's a $5 trillion behemoth, nearly 20% of the U.S. economy or more than $15,000 per person per year. The cost of health care for consumers, including the cost of health insurance continues to increase.
On this episode, we sat down with two people who pay close attention to the health care market and to how state legislatures are responding to rising costs. Our first guest is Katie Martin is CEO, and president of the Health Care Cost Institute, a nonprofit research group that collects and analyzes data on health care costs in the U.S. Also joining the discussion is Sarah Jaromin, who tracks health care issues for NCSL.
Martin noted that her organization taps into data from employers who provide insurance to about half the people in the U.S. as well as data from Medicare and Medicaid. She pointed out that as of 2023, health care costs had increased more than 50% since 2014, and the trend does not show any signs of slowing.
Jaromin sketched out the legislative landscape and explained how legislatures have tried to slow the growing cost of health care. She noted that NCSL has collected data showing that last year, 48 states, along with Puerto Rico, the Virgin Islands and Washington ,D.C., enacted nearly 500 bills related to health care costs and delivery.
“2025 Legislative Landscape: States Tackle Health Costs, Coverage and Delivery,” NCSL
“Annual Health Care Cost Utilization Report,” HCCI
“From Mergers to Market Power: 2025 Legislative Recap on Health Care Consolidation,” NCSL
“From Prenatal to Postpartum Care, Total Spending on Childbirth Averaged over $25,000 among ESI Enrollees,” HCCI
Health Care Cost Institute
“Health Costs, Coverage and Delivery State Legislation,” NCSL
“Issue Brief: System-affiliated hospitals associated with higher prices,” HCCI
“Most Office Visit Facility Fee Spending is on Internal Medicine,” HCCI
Prices in Hospital Outpatient Departments are Consistently Higher than Physician Offices among Site-Neutral Services, HCCI