Clark Howard Reveals the Real Reason Your Health Insurance Costs Keep Climbing

Open enrollment notices are arriving now, and many renewal prices will be hard to look at. On October 2, 2026, consumer money expert Clark Howard warned listeners on The Clark Howard Podcast about what’s coming: “States where people are peeling away from having health insurance, insurance premiums are going up, could be 20% next year over this year.” In states where fewer people drop coverage (i.e., where more people remain insured), premiums “may be going up 10 or so percent.”

That gap matters in dollars. A $600 monthly plan increased by 20% becomes $720 per month, or $1,440 more per year. At 10%, it becomes $660 per month, or $720 more per year. Same coverage, different zip code, very different cost.

The split reflects who stays in the insurance pool. Healthy people drop coverage first when prices rise. Sicker people remain and file more claims, driving up costs. Insurance companies charge everyone remaining more to cover those claims. Higher prices push out the next group of healthy people, and the cycle repeats.

Howard’s Blunt Diagnosis of a Broken System

A shrinking pool explains rising premiums. Hospital pricing power explains why care costs so much. Howard said on the podcast: “I can’t sugarcoat this at all. We are broken right now in the healthcare sector. Most of it stems from the concentrated power of hospital systems in metro areas, where they achieve monopolies and use that position to drive up the price of everything.”

How One Hospital System Ends Up Setting Your Premium

Concentration builds over time. A big system combines with rivals, then buys independent hospitals, physician practices, imaging centers, and urgent care clinics. Within a decade, one or two systems control most hospital beds and specialists in the metro area.

Insurance companies need networks that people will buy. A plan without the region’s main hospital, trauma center, or children’s hospital is hard to sell. The hospital system knows this. When contracts renew, it demands higher rates, leaving insurance companies with few options.

For example, an insurance company pays $1,000 for an MRI in a competitive city. In a city with one dominant system, the same scan costs $2,500, 2.5 times more. The machine and scan are identical; the only difference is who sets the price.

Insurance companies pass that cost along. Premiums are based on expected claims, and federal rules require insurance companies to spend a fixed minimum share of premium dollars on care. Higher hospital prices show up directly in your premium. Hospital-owned doctors’ offices add facility fees too. Same doctor, same visit, bigger bill.

Why Blaming Your Insurer Misses Where the Money Goes

Howard said, “Everybody loves to hate insurers. The real problem here is not the insurers. It’s a concentration of power in medicine city by city of major hospital systems. You want to see where the money’s really going, that’s where it’s going.”

Your local hospital market’s concentration matters most. In competitive cities, narrower-network plans cost less because insurers direct patients toward lower-cost providers. In cities with one dominant system, almost every plan includes it, so premiums are high across the board. Your savings then come from managing deductibles and choosing where you receive outpatient care.

What You Actually Control During Open Enrollment

• Skip auto-renewal. Compare your renewal premium against at least two other plans on your state exchange or employer benefits menu, since plans are repriced yearly.
• Check networks facility by facility. Look up specific hospitals, labs, and imaging centers you’d use. A cheaper plan might not cover the dominant system.
• Calculate total yearly cost. Multiply the monthly premium by 12, then add the deductible for a realistic cost estimate, and the out-of-pocket maximum for a worst-case scenario. The lowest-premium plan often loses this comparison once you factor in anticipated care use.
• Use independent outpatient providers. In-network imaging centers and labs not owned by hospital systems often charge less. Ask whether the location charges a facility fee.
• Know the limits of switching. A new plan changes how much of the bill you pay, but the hospital still sets the underlying charge.

Your insurance company sends the bill, but hospital pricing power in your city determines most of it — so choose your plan based on which facilities it covers.

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