This content has been sponsored by Blue Cross Blue Shield Association.
Health care costs in the United States are a burden that nearly every American feels in one way or another.
For many families, a trip to the doctor or a visit to the emergency room can lead to unexpected bills that strain budgets.
“Rising health care costs are a financial anchor,” said David Merritt, senior vice president for external affairs at Blue Cross Blue Shield Association (BCBSA). “Private sector leaders, government leaders, physician leaders and hospital leaders need to come together to address this crisis together.”
Roadmap for reducing health care costs
BCBSA recently published a roadmap that lays out ways to reduce health care spending by nearly $1 trillion over the next decade.
It focuses on three areas:
- Fair hospital billing: “Hospitals account for more than half of all health care spending,” Merritt said. “There are effective, commonsense solutions that can bring down the costs that hospitals charge and can save upwards of about half a trillion dollars.”
- Prescription drug pricing: Prescription costs are another major concern. Increasing competition in the pharmaceutical industry would give patients more choices and lower prices, Merritt said.
- Hospital consolidation: “The third area is around consolidation,” he said. “Consolidation actually constrains choices and limits competition, so we think taking that on — not only in the pharmaceutical space but also on the corporate health system side — you will have more choices at a lower cost.”
Merritt said that one of the clearest examples of inflated pricing is site-based billing, where patients are charged dramatically different amounts for the same procedure depending on where it’s performed.
A patient could see the same doctor and receive the same treatment, but if it happens in a hospital instead of a doctor’s office, the cost could be five to seven times higher.
That disparity has fueled interest in site-neutral payment policies.
“Those policies are meant to protect patients from paying higher costs simply because they were treated at a hospital versus a doctor’s office,” Merritt said.
The issue is gaining traction on Capitol Hill, where lawmakers from both parties see an opportunity to address it.
“Even in the polarized politics that we have now, this is one of the bright spots of bipartisan support,” Merritt said. “It’s common sense because we don’t need to pay five times more for a procedure simply because of where it’s delivered.”
A leader on Capitol Hill
A vocal advocate for lowering health care costs is Rep. Lauren Underwood (R-IL), who represents the state’s 14th Congressional District in the U.S. House.
She has championed H.R. 247, the Health Care Affordability Act of 2025, which would permanently extend the enhanced premium tax credits that help make health insurance policies through the Affordable Care Act more affordable.
Four out of five Americans have been able to purchase a plan using the individual marketplace for $10 or less a month, Underwood said.
The tax credits have been incredibly impactful over the years, she said. “We had the lowest number of uninsured Americans in U.S. history, and now we are in a fight to extend these tax credits because they are set to expire at the end of this calendar year.”
An extension of the tax credits was not included in the multitrillion-dollar federal tax and spending package, known as the “One Big Beautiful Bill Act.”
That has Underwood deeply concerned about what might happen next.
“Taking away or reducing these tax credits for health care coverage will make the cost of care unaffordable for millions,” she said, adding, “We’re talking about 22 million Americans who are going to see the cost of their coverage go up dramatically.”
What’s more, 93% of marketplace enrollees receive premium tax credits with an average savings of $700.
“People will be spending more money every month on their health care,” Underwood said. “People will just go without filling their prescriptions or go without getting recommended procedures.”
According to Underwood, the Congressional Budget Office released a projection showing that the average 21-year-old would see a monthly increase of $411, and for older Americans, the increase would be around $1,200 on the cost of their premiums.
The tax credits were designed to lower the burden of having health insurance and to make coverage more affordable. “It benefits all consumers when more Americans have access to high-quality, affordable care,” Underwood said.
Discover more perspectives from WTOP’s The Health Care Agenda 2025: Real Policies for Real People on our event page.
