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Coinsurance is the percentage of a healthcare bill that you’re splitting with the health insurance company. Policies usually have an annual deductible, which is what you pay toward healthcare before the health plan begins paying a portion. Once you exceed the deductible, you then pay coinsurance toward healthcare bills. For instance, you may pay 40% of the healthcare bill and the health insurance company picks up the other 60%. I’ve found that the coinsurance amount can play an important role in healthcare costs if you need regular health services.

It depends on how often you use healthcare services. A premium is what you pay for coverage; the deductible is what you pay for healthcare services annually before the health plan begins paying its share. I’ve found that a premium is generally more important but it can vary. For instance, if you regularly exceed your deductible, that cost may be equally or more important. You’ll want to weigh the costs based on your experience.

Health insurance shopping isn’t often the easiest or most pleasant task, but we’ve done much of the work for you by looking at factors that often play a role when choosing a health plan. We analyzed nearly 720 health insurance costs from eight insurers, reviewed complaints, customer satisfaction, metal tiers and the types of plans offered in the marketplace. See our top picks below to find the coverage that matches your needs.

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Universal health care Should the U.S. government provide universal health care? (more)

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Some 25.3 million non-elderly Americans did not have health insurance in 2023, a decline from 28.9 million uninsured Americans in 2019. The largest group of Americans, 154 million non-elderly people, were covered by employer-sponsored health insurance. Less than 1 percent of Americans over 65 were uninsured, thanks to Medicare, a government provided insurance for people over 65 years old. [162][163] According to the Commonwealth Fund’s health survey, reported in 2023, the United States among “high-income countries” has “the lowest life expectancy at birth, the highest death rates for avoidable or treatable conditions, the highest maternal and infant mortality, and among the highest suicide rates.” The country also has the highest rate of people with multiple chronic conditions and an obesity rate nearly twice the average of other high-income countries. Given these medical challenges, it is not surprising that health care spending has remained far higher in the U.S. than in other high-income countries. “Yet the U.S. is the only [high-income] country that doesn’t have universal health coverage.”[171][178] Instead, health care in the United States is largely a private system, through employer-sponsored plans from private insurance companies; it is not a public, universal system. The U.S. does offer universal health care through special programs for certain segments of the population with special needs, such as Medicare for seniors age 65 or older, Medicaid for low-income individuals under age 65, and TRICARE for past and present military members and their families. For this reason, U.S. health care, though fundamentally a private affair, is often called a mixed system.[171][178][184]

What Is Universal Healthcare? Universal health care is an umbrella term for “a system that provides medical services to all people. The government offers it to everyone regardless of their ability to pay, and largely funds it through taxes,” according to economic expert Kimberly Amadeo. [178] Single-payer health care is one type of universal health care in which the “government provides free health care paid for with revenue from income taxes.… Every citizen has the same access to care”; service providers may be public or private health care facilities, but the care is free at the point of service. Contrary to a multipayer system, in which various entities—such as employers, individuals, or private insurance companies—can pay for the health care, a “single-payer” system is so-called because only one entity (the federal government) pays for the health services; a single-payer system eliminates the role of private insurance companies and replaces them with government-funded services. The United Kingdom, Spain, New Zealand, and Cuba have single-payer systems. In the U.S., military personnel and veterans have access to a single-payer system via the armed services and the Department of Veterans Affairs. [178][225][226] Social health insurance is also a kind of universal health care in which “everyone [is required] to buy insurance, usually through their employers. Employers deduct taxes from employee payrolls to cover the costs, and the taxes go into a government-run health insurance fund that covers everyone. Private doctors and hospitals provide services. The government controls health insurance prices.” Germany, France, Belgium, the Netherlands, Japan, and Switzerland use the social health insurance model. Obamacare was originally modeled on social health insurance, however the program has changed. [178] National health insurance is yet another kind of universal health care, one that “uses public insurance to pay for private-practice care. Every citizen pays into the national insurance plan. Administrative costs are lower because there is one insurance company. The government also has a lot of leverage to force medical costs down.” Canada, Taiwan, and South Korea all have national health insurance. In the U.S., Medicare, Medicaid, and TRICARE function similarly.[178][184] Countries with universal healthcare include but are not limited to Australia, Brazil, Canada, China, Denmark, England, France, Germany, India, Israel, Italy, Japan, the Netherlands, New Zealand, Norway, Singapore, Sweden, Switzerland, and Taiwan. [178][179] A December 29, 2024, Gallup poll found that 62 percent of Americans believed that it is the U.S. government’s responsibility to “ensure all Americans have healthcare coverage,” compared to 36 percent who do not believe health care coverage is the federal government’s responsibility. Americans are split—46 percent to 49 percent respectively—on whether that healthcare should be a national, government-run system or a private insurance system. [224]

Health Care Spending U.S. health care spending rose 2.7 percent in 2021 to a total of $4.3 trillion nationally and accounted for 18.3 percent of the U.S. Gross Domestic Product (GDP). Of the $4.3 trillion, health insurance paid 71 percent (with private insurance paying 28 percent, and government programs covering the rest via Medicare, Medicaid, and other programs), patients paid 10 percent as did other third party payers (such as the Indian Health Service), investment covered 5 percent, and government public health activities accounted for 4 percent. Per person, health care costs averaged $12,914. [164][165] [166] 56 percent of Americans were worried about “paying medical costs for serious illness or accident” in 2022. As a financial worry, it was only topped by the worry of “not having enough money for retirement.” Additionally, 43 percent were worried about “paying medical costs for normal healthcare,” which was the fourth most prevalent financial worry in 2022. Meanwhile, 20 percent of American adults reported “major, unexpected medical expenses” with an average cost of $1,000 to $1,999 between May 2021 and May 2022. [167][168] In 2022, 41 percent of American adults, about 100 million people, were in medical debt. Over 50 percent of American adults reported going into debt because of medical (or dental) bills. 25 percent of those with medical debt owe more than $5,000 and about 20 percent don’t believe they will ever be able to pay off the debt. [169] A March 2025 Gallup poll found 12 percent of American adults (about 31 million people) borrowed an estimated $74 billion collectively to cover medical costs in 2024. [223] People in medical debt cut spending on basics like food and clothing (63 percent), exhausted their savings (48 percent), had to take on extra work (40 percent), delayed a home purchase or their education (28 percent), asked for help from a charity (24 percent), and/or changed their living situation (19 percent). And, 17 percent of those in medical debt filed bankruptcy or lost their home as a result. A 2019 study found that of people who file for bankruptcy, about 67 percent file due to medical debt, with about 530,000 families in the United States filing for bankruptcy annually because of medical debt. [169][170]

Health Care in a Global Context The World Health Organization ranked the U.S. health care system at 37 out of its 191 member countries, between Costa Rica and Slovenia, in a landmark 2000 report. [108] In 2005 the United States and the other member states of the World Health Organization signed the World Health Assembly resolution 58.33, which stated that nations should “transition to universal coverage of their citizens… with a view to sharing risk among the population and avoiding catastrophic health-care expenditure and impoverishment of individuals as a result of seeking care.” [16][107] The Commonwealth Fund ranked the United States last in overall health care among 11 high-income countries based on access to care, care process, administrative efficiency, equity, and health care outcomes. Norway, the Netherlands, and Australia were the top three countries. [172] The United States spends $11,912 per person on health care, the most of any OECD country. Germany follows the U.S. with $7,382 per person, while South Korea spent the least at $3,914 per person. [173] A January 31, 2023, Commonwealth Fund report found that the United States “spends nearly 18 percent of GDP on health care, yet Americans die younger and are less healthy than residents of other high-income countries” and “[n]ot only does the U.S. have the lowest life expectancy among high-income countries, but it also has the highest rates of avoidable deaths.” According to the report, the U.S. spends much more than the other 37 OECD (Organisation for Economic Co-operation and Development; members are countries generally considered “high-income” or “developed”) countries, per person and as a percentage of GDP, and is the only OECD country that does not have universal health care. [171] Further, the U.S. has the highest maternal and infant mortality rates, among the highest suicide rate, the highest rate of patients with multiple chronic illnesses, and the highest obesity rate. And yet the U.S. also has one of the lowest levels of doctors and hospital beds, and Americans are least likely to visit a doctor. The Commonwealth Fund concluded, “Not only is the U.S. the only country we studied that does not have universal health coverage, but its health system can seem designed to discourage people from using services.” [171]

Obamacare and Medicare for All During an October 7, 2008 election debate, then-Senator Barack Obama stated that health care should be a “right for every American.” In a June 15, 2009 speech as U.S. President delivered to the American Medical Association (AMA), Obama urged Congress to craft legislation that would ensure coverage for all Americans. After intense debate, lawmakers passed the Patient Protection and Affordable Care Act (PPACA), also called the Affordable Care Act (ACA) or Obamacare, which was signed into law on March 23, 2010. According to a 2013 White House estimate, 27 million previously uninsured people would gain coverage under Obamacare. [22][34][35][36][46] About 8 percent of Americans remained uninsured in 2022, about 26 million people, the lowest percentage in decades due largely to changes in policy during the COVID-19 (coronavirus) pandemic. By 2023, more than 16 million Americans had health insurance via Obamacare, the highest number since the PPACA was signed in 2010. The 2023 enrollees included about 3.6 million people who were not previously enrolled in Obamacare. As of January 8, 2025, almost 24 million people had health insurance under the PPACA. More than 300 million Americans were covered by health insurance, or about 92 percent according to the U.S. Census. [176][177][222] The PPACA did not institute universal health care, and some members of Congress, including Senator Bernie Sanders (I-VT) and Representative Jim McDermott (D-WA), and organizations, including Physicians for a National Health Program (PNHP) and the American Nurses Association, continued to advocate for the implementation of a “single-payer” health care system in the United States that would guarantee universal health care for all Americans under a federally run health insurance plan. [27][28][39][40] On September 13, 2017, Senator Sanders introduced a Medicare for All bill that would have created a single-payer health care system in the United States. His bill, which had been introduced previously without any co-sponsors, drew at least 15 Senate co-sponsors. However, the plan did not pass Congress. [116] Medicare for All became a hot button topic in the 2020 presidential election. Only the Green Party candidate, Howie Hawkins, supported the plan, while Joe Biden (D), Donald Trump (R), and Libertarian candidate Jo Jorgensen did not.

Public Opinion Gallup has asked Americans whether the government should ensure health care since 2000. The first year (2000), 59 percent agreed that the government should ensure health care. Support hit a low in 2013, when 43 percent agreed, but support rebounded and, by 2022, 57 percent supported government ensured heath care. 53 percent were partial to a private insurance based system, while 43 percent were partial to a government-run system. [175] The partisan divide is stark, however: 88 percent of Democrats and 59 percent of Independents agreed that “it is the responsibility of the federal government to make sure all Americans have healthcare coverage,” while only 28 percent of Republicans agreed. Further, 72 percent of Democrats, 46 percent of Independents, and 13 percent of Republicans support a government-run health care system. [175]

Pros and Cons at a Glance PROS CONS Pro 1: The U.S. already has universal health care for some. The government should expand the system to protect everyone. Read More. Con 1: Universal health care would be marred by government inefficiency and ignore the realities of the country and free market. Read More. Pro 2: Universal health care would lower costs and prevent medical bankruptcy. Read More. Con 2: Universal health care would raise costs for the federal government and taxpayers alike. Read More. Pro 3: Universal health care would improve individual and national health outcomes. Read More. Con 3: Universal health care would increase wait times for basic care and worsen Americans’ ill-health. Read More.

Health plans under major U.S. insurers said Monday they have voluntarily agreed to speed up and reduce prior authorizations – a process that is often a major pain point for patients and providers when getting and administering care.

Prior authorization makes providers obtain approval from a patient’s insurance company before they carry out specific services or treatments. Insurers say the process ensures patients receive medically necessary care and allows them to control costs. But patients and providers have slammed prior authorizations for, in some cases, leading to care delays or denials and physician burnout.

Dozens of plans under large insurers such as CVS Health , UnitedHealthcare , Cigna , Humana , Elevance Health and Blue Cross Blue Shield committed to a series of actions that aim to connect patients to care more quickly and reduce the administrative burden on providers, according to a release from AHIP, a trade group representing health plans. Though the companies cheered the changes, they could cut into profits if they lead to patients using care more often.

“The American health care system must work better for people, and we will improve it in distinctive ways that truly matter,” said Steve Nelson, president of CVS’ insurer, Aetna, in a statement. “We support the industry’s commitments to streamline, simplify and reduce prior authorization.”

Insurers will implement the changes across markets, including commercial coverage and certain Medicare and Medicaid plans. The group said the tweaks will benefit 257 million Americans.

Among the efforts is establishing a common standard for submitting electronic prior authorization requests by the start of 2027. By then, at least 80% of electronic prior authorization approvals with all necessary clinical documents will be answered in real time, the release said.

That aims to streamline the process and ease the workload of doctors and hospitals, many of whom still submit requests manually on paper rather than electronically.

Individual plans will reduce the types of claims subject to prior authorization requests by 2026.

“We look forward to collaborating with payers to ensure these efforts lead to meaningful and lasting improvements in patient care,” said Shawn Martin, CEO of the American Academy of Family Physicians, in the release.