{"id":414855,"date":"2026-04-28T13:02:10","date_gmt":"2026-04-28T13:02:10","guid":{"rendered":"https:\/\/www.newsbeep.com\/il\/414855\/"},"modified":"2026-04-28T13:02:10","modified_gmt":"2026-04-28T13:02:10","slug":"why-cant-americans-buy-more-affordable-health-care-plans","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/il\/414855\/","title":{"rendered":"Why can\u2019t Americans buy more affordable health-care plans?"},"content":{"rendered":"<p class=\"article-content mb-150 text-112 leading-160 lg:text-125 lg:leading-200\">When the Affordable Care Act (ACA) was being assembled in 2010, presidential advisor Jason Furman <a href=\"https:\/\/web.stanford.edu\/~leinav\/pubs\/JPAM2024b.pdf\" rel=\"nofollow noopener\" target=\"_blank\">said<\/a>, \u201cPresident Obama often told us he wanted us to design a Yugo of a plan, referring to a basic, inexpensive Yugoslavian car.\u201d Things didn\u2019t work out that way because \u201cjust about every outside group and person engaged with the plan design took the opposite view, arguing that it should cover a very wide range of medical treatments and choices.\u201d<\/p>\n<p class=\"article-content mb-150 text-112 leading-160 lg:text-125 lg:leading-200\">Yugos are no longer available, but the auto industry still offers a variety of options targeted at different market segments. The price of new cars range from the <a href=\"https:\/\/www.kia.com\/us\/en\/k4\" rel=\"nofollow noopener\" target=\"_blank\">Kia K4<\/a> sedan, starting at $22,290, to the <a href=\"https:\/\/www.thedrive.com\/news\/the-4-6-million-bugatti-tourbillon-looks-certifiably-strange-on-steelies\" rel=\"nofollow noopener\" target=\"_blank\">Bugatti Tourbillon,<\/a> at $4.6 million. The Bugatti might be more fun and stylish, but both take about the same time to get you from Connecticut to Manhattan during rush hour.<\/p>\n<p class=\"article-content mb-150 text-112 leading-160 lg:text-125 lg:leading-200\">If we can produce cars for such different price ranges, why can\u2019t we do the same for health care?<\/p>\n<p class=\"font-bold text-[#0a0a0a] text-150 font-sans text-center md:text-left\">City Journal is the premier journal on urban policy<\/p>\n<p class=\"font-sans pb-200 text-100 text-center leading-150 text-[#0a0a0acc]\/80 md:pb-0 md:text-left\">Sign up for free to receive daily highlights.<\/p>\n<p><img alt=\"\" loading=\"lazy\" width=\"364\" height=\"364\" decoding=\"async\" data-nimg=\"1\" class=\"w-[364px] max-w-none\" style=\"color:transparent\" src=\"https:\/\/ripple-prod-cdn.site.aws.wapo.pub\/ripple_nologo.svg\"\/><img alt=\"\" loading=\"lazy\" width=\"230\" height=\"230\" decoding=\"async\" data-nimg=\"1\" class=\"size-[115px] max-w-none rounded-full object-cover z-[1]\" style=\"color:transparent\"  src=\"https:\/\/www.newsbeep.com\/il\/wp-content\/uploads\/2026\/04\/imrs.webp\"\/><\/p>\n<p>Submit a guest post to Ripple<\/p>\n<p class=\"article-content mb-150 text-112 leading-160 lg:text-125 lg:leading-200\">Want to contribute to Ripple? <a href=\"https:\/\/forms.gle\/WfdysBfRyh6ARvbk8\" target=\"_blank\" rel=\"nofollow noopener\">Share your idea with us here<\/a> and we\u2019ll provide guidance and feedback. Successful pieces may be featured on the site.<\/p>\n<p class=\"article-content mb-150 text-112 leading-160 lg:text-125 lg:leading-200\">This year, the benchmark health insurance <a href=\"https:\/\/www.kff.org\/affordable-care-act\/state-indicator\/marketplace-average-benchmark-premiums\/\" rel=\"nofollow noopener\" target=\"_blank\">premium<\/a> on the individual market rose to $7,500. Health insurance costs are rising because of the <a href=\"https:\/\/www.city-journal.org\/article\/health-care-insurance-costs-medical-services\" rel=\"nofollow noopener\" target=\"_blank\">growing use<\/a> of expensive new medical services. As people get wealthier, they <a href=\"https:\/\/randomcriticalanalysis.com\/why-conventional-wisdom-on-health-care-is-wrong-a-primer\/\" rel=\"nofollow noopener\" target=\"_blank\">spend<\/a> more on health care. A recent Harvard <a href=\"https:\/\/www.journals.uchicago.edu\/doi\/pdf\/10.1086\/734328\" rel=\"nofollow noopener\" target=\"_blank\">study<\/a> estimated that the surge in U.S. health-care spending from 1970 to 2019 owed mostly to rising incomes (43 percent) and expanded medical capabilities (35 percent) rather than demographic changes (9 percent) and price increases (8 percent).<\/p>\n<p class=\"article-content mb-150 text-112 leading-160 lg:text-125 lg:leading-200\">Health care is not an all-or-nothing commodity, but an array of goods and services with <a href=\"https:\/\/www.aeaweb.org\/articles?id=10.1257\/jel.50.3.645\" rel=\"nofollow noopener\" target=\"_blank\">differing levels<\/a> of cost, effectiveness, and convenience. Highly effective antibiotics <a href=\"https:\/\/www.goodrx.com\/amoxicillin?srsltid=AfmBOooiep6UDcC42O17WX-LT7IG9TURhJy0Jrxhuudzv0-C0x5ISUep\" rel=\"nofollow noopener\" target=\"_blank\">costing<\/a> a few dollars occupy one end of the spectrum; cancer drugs that extend life by only a month or two but <a href=\"https:\/\/academic.oup.com\/healthaffairsscholar\/article\/3\/4\/qxaf051\/8074216\" rel=\"nofollow noopener\" target=\"_blank\">cost<\/a> $200,000 occupy the other.<\/p>\n<p class=\"article-content mb-150 text-112 leading-160 lg:text-125 lg:leading-200\">Hospitals <a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1475-6773.12101\" rel=\"nofollow noopener\" target=\"_blank\">adjust their<\/a> operating expenses in response to patient fees. <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0167629622000558\" rel=\"nofollow noopener\" target=\"_blank\">High-priced facilities<\/a> have more up-to-date technology, better credentialed physicians, shorter emergency room wait times, and better heart attack survival rates. Private rooms cost more but allow patients to <a href=\"https:\/\/journals.sagepub.com\/doi\/abs\/10.1177\/1937586718755110\" rel=\"nofollow noopener\" target=\"_blank\">recover<\/a> with better sleep and lower infection rates. Hospitals also <a href=\"https:\/\/www.nber.org\/system\/files\/working_papers\/w14619\/w14619.pdf\" rel=\"nofollow noopener\" target=\"_blank\">compete<\/a> for well-insured patients with gourmet food and impressive architecture.<\/p>\n<p class=\"article-content mb-150 text-112 leading-160 lg:text-125 lg:leading-200\">The willingness to pay for marginal improvements in health care varies significantly with income. A household earning $250,000 can reasonably see health insurance costing $25,000 as a prudent use of 10 percent of its income, but a family earning $50,000 could struggle to afford housing, food, and basic utilities if forced to purchase the same package of benefits. Economists Mark Shepard, Katherine Baicker, and Jonathan Skinner <a href=\"https:\/\/www.journals.uchicago.edu\/doi\/pdf\/10.1086\/708168\" rel=\"nofollow noopener\" target=\"_blank\">note<\/a> that \u201crising income inequality makes it more difficult to design a single plan that serves the needs of both higher- and lower-income people.\u201d<\/p>\n<p class=\"article-content mb-150 text-112 leading-160 lg:text-125 lg:leading-200\">Many Americans <a href=\"https:\/\/www.nytimes.com\/2019\/09\/09\/us\/politics\/bernie-sanders-health-care.html\" rel=\"nofollow noopener\" target=\"_blank\">laud the low cost<\/a> of Canada\u2019s single-payer health-care system, which imposes a low level of consumption on everyone. It costs <a href=\"https:\/\/www.healthsystemtracker.org\/chart-collection\/health-spending-u-s-compare-countries\/\" rel=\"nofollow noopener\" target=\"_blank\">half as much<\/a> per capita as America\u2019s but rations access to specialty care and limits access to treatment with <a href=\"https:\/\/www.fraserinstitute.org\/studies\/waiting-your-turn-wait-times-for-health-care-in-canada-2025\" rel=\"nofollow noopener\" target=\"_blank\">waiting lists<\/a>, producing consistently <a href=\"https:\/\/media4.manhattan-institute.org\/wp-content\/uploads\/americas-surprisingly-effective-welfare-state.pdf#page=29\" rel=\"nofollow noopener\" target=\"_blank\">worse outcomes<\/a> for seriously ill patients. Canada also <a href=\"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/9780776628080\/html#contents\" rel=\"nofollow noopener\" target=\"_blank\">prohibits<\/a> the sale of supplemental private insurance to stop wealthier patients from bypassing wait times, which would distort the intended rationing of medical resources.<\/p>\n<p class=\"article-content mb-150 text-112 leading-160 lg:text-125 lg:leading-200\">The United States does not try to ration medical care. It suffers from the <a href=\"https:\/\/www.city-journal.org\/article\/paying-the-price\" rel=\"nofollow noopener\" target=\"_blank\">opposite problem<\/a>\u2014people lack any alternative to comprehensive health-care plans that they can\u2019t afford. Insurance <a href=\"https:\/\/content.naic.org\/sites\/default\/files\/consumer-health-insurance-what-is-medical-necessity.pdf\" rel=\"nofollow noopener\" target=\"_blank\">legally must finance<\/a> all \u201cmedically necessary\u201d goods and services, regardless of their cost or effectiveness. This is why <a href=\"https:\/\/inequality.stanford.edu\/sites\/default\/files\/media\/_media\/pdf\/pathways\/winter_2009\/Gruber.pdf\" rel=\"nofollow noopener\" target=\"_blank\">many<\/a><a href=\"https:\/\/pubs.aeaweb.org\/doi\/pdf\/10.1257\/jep.37.2.99\" rel=\"nofollow noopener\" target=\"_blank\">economists<\/a><a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pam.22602\" rel=\"nofollow noopener\" target=\"_blank\">support<\/a> letting people choose between different tiers of health insurance coverage with varying cost levels. A 2010 study <a href=\"https:\/\/www.jstor.org\/stable\/pdf\/27805044.pdf\" rel=\"nofollow noopener\" target=\"_blank\">estimated<\/a> that workers would be willing to forgo 10 percent to 40 percent or more of their employer funds for the right to choose their own plans.<\/p>\n<p class=\"article-content mb-150 text-112 leading-160 lg:text-125 lg:leading-200\">Why can\u2019t Americans buy more affordable plans here? And why is there no insurance option that covers just the medical services <a href=\"https:\/\/media4.manhattan-institute.org\/wp-content\/uploads\/keeping-medicare-affordable-the-cost-of-adding-services.pdf#page=6\" rel=\"nofollow noopener\" target=\"_blank\">available<\/a> in the 1990s, at an equivalent price?<\/p>\n<p class=\"article-content mb-150 text-112 leading-160 lg:text-125 lg:leading-200\">The Affordable Care Act is part of the problem. The legislation required insurers to sell plans on the same terms without regard to enrollees\u2019 medical risks, which <a href=\"https:\/\/www.hoover.org\/sites\/default\/files\/uploads\/documents\/9780817910440_1.pdf#page=23\" rel=\"nofollow noopener\" target=\"_blank\">incentivized<\/a> plans to eliminate benefits that would be disproportionately appealing to seriously ill enrollees. Sicker patients are willing to pay almost <a href=\"https:\/\/julianreif.com\/research\/reif.jpube.2025.healthrisk.pdf\" rel=\"nofollow noopener\" target=\"_blank\">twice as much<\/a> for the same improvements in health. In Massachusetts, when an insurance plan began to cover the best cancer hospitals, its <a href=\"https:\/\/mshepard32.github.io\/website\/EconJournals\/Shepard_2022AER_HospitalNetworkCompetitionAdverseSelection.pdf\" rel=\"nofollow noopener\" target=\"_blank\">cost surged<\/a> as it attracted a rush of seriously ill enrollees.<\/p>\n<p class=\"article-content mb-150 text-112 leading-160 lg:text-125 lg:leading-200\">To stop a race to the bottom in the scope of benefits, the ACA <a href=\"https:\/\/manhattan.institute\/article\/the-perils-of-fixing-out-of-network-health-care-prices\" rel=\"nofollow noopener\" target=\"_blank\">imposes<\/a> highly prescriptive benefit mandates and network-adequacy requirements. This has frustrated both affluent individuals willing to pay a premium for top-tier medical access and those with modest incomes who prefer more affordable health-care options.<\/p>\n<p class=\"article-content mb-150 text-112 leading-160 lg:text-125 lg:leading-200\">A better alternative? Let households purchase insurance options <a href=\"https:\/\/manhattan.institute\/article\/renewable-term-health-insurance\" rel=\"nofollow noopener\" target=\"_blank\">exempt<\/a> from ACA rules. This shift would enable plans to offer higher-quality benefits without attracting an influx of beneficiaries who waited until they\u2019re seriously ill to enroll. While some progressives have disparaged non-ACA plans as \u201cjunk insurance,\u201d these plans <a href=\"https:\/\/manhattan.institute\/article\/continuous-renewable-coverage-rx-for-americas-dysfunctional-health-insurance-system\" rel=\"nofollow noopener\" target=\"_blank\">provide<\/a> access to the highest-rated national facilities such as the Cleveland Clinic, Memorial Sloan Kettering, and Mass General Hospital\u2014which ACA plans typically lack.<\/p>\n<p class=\"article-content mb-150 text-112 leading-160 lg:text-125 lg:leading-200\">One-size-fits-all coverage may be an inevitable consequence of single-payer health care systems. It need not be a feature of American private insurance.<\/p>\n","protected":false},"excerpt":{"rendered":"When the Affordable Care Act (ACA) was being assembled in 2010, presidential advisor Jason Furman said, \u201cPresident Obama&hellip;\n","protected":false},"author":2,"featured_media":414856,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[163,521,85,46],"class_list":["post-414855","post","type-post","status-publish","format-standard","has-post-thumbnail","category-healthcare","tag-health","tag-healthcare","tag-il","tag-israel"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/414855","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/comments?post=414855"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/414855\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media\/414856"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media?parent=414855"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/categories?post=414855"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/tags?post=414855"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}