A new National Association of Insurance Commissioners working group has started work on health care affordability. The goal is practical.
Deliver policy options states can use to slow rising costs and premiums. Regulators want output by the end of the year, not a drawn-out process.
The Health Care Affordability and Mitigation Working Group held its first meeting last week. Members outlined a tight 2026 schedule.
The focus stays on identifying cost drivers and translating them into policy responses. Not theory. Actionable steps, according to participants.
Kate Harris, chief deputy commissioner at the Colorado Division of Insurance, leads the group. She pushed the discussion toward solutions rather than repeating known problems.
Regulators already understand pressure points in the system. The gap sits in execution, what works, where, and under which constraints.
The group plans to examine core cost drivers. Hospital pricing sits high on the list. Prescription drug spending continues to climb. Benefit design also shapes how costs flow into premiums. Each factor feeds directly into insurance pricing structures.
Instead of producing a long report, the group leans toward shorter policy briefs. Each would focus on a specific tool or reform. The format aims to help state policymakers move faster.
The group will rely heavily on state-level experience. Ideas tested in one state could scale elsewhere, though not always cleanly.
Colorado’s state-run program will likely enter the discussion. The Colorado Option requires insurers to offer standardized plans in individual and small group markets.
Private insurers still administer those plans. Anthem and Kaiser Permanente participate. The model blends regulation with private delivery, though results vary depending on pricing controls.
Health care costs continue to rise at their fastest pace in more than 15 years. Several forces drive that trend. Medical innovation brings higher prices. Federal policy changes add pressure across coverage markets.
Prescription drug spending takes a larger share of total costs. It moved from around 22% to above 25%, according to regulators. That shift alone reshapes premium calculations.
The group may pull from existing NAIC research on pharmaceutical pricing.
Hospital pricing drew sharper comments. Nebraska questioned underlying cost structures. NAIC pointed to continued expansion projects despite reported margin pressure. The gap between reported costs and billed charges remains unclear in many cases.
Facility fees add another layer. Those charges push patients away from care. Patients delay visits or skip treatment. They shift, often worsening outcomes and future spending.
The group set a compressed timeline. An outline is expected by late April. Feedback follows in May. Drafting begins over the summer. A preliminary version could appear by late summer or early fall. Final delivery targets the NAIC winter meeting.
Industry groups plan to participate. AHIP signaled it will contribute research and policy proposals. According to Beinsure analysts, collaboration between regulators and industry tends to shape final recommendations, though alignment rarely comes easy.
