No healthcare premiums? In this economy?! Here's how.

Summary

Podcast Summary: No Healthcare Premiums? In This Economy?! Here’s How.

Podcast: The Indicator from Planet Money (NPR)
Episode Date: March 9, 2026
Host: Adrian Ma
Guest: Maria Aspen (NPR Financial Correspondent)
Theme: Exploring how some U.S. employers are offering "no premium" health insurance plans for employees—what it looks like, why they do it, and the trade-offs involved.

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Episode Overview

This episode offers a snapshot of the skyrocketing costs of healthcare in the U.S. while diving into a relatively rare but growing practice: employers covering 100% of employees’ health insurance premiums. Through interviews with small and large employers, the hosts explore the motivations, potential benefits, and hidden caveats of these plans, questioning whether employer-led solutions can make a dent in the larger issues plaguing American healthcare.

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Key Discussion Points & Insights

1. The Broken Economics of U.S. Healthcare

• U.S. healthcare is the most expensive in the developed world, and health insurance premiums are rising rapidly.
• Sticker shock is particularly harsh for immigrants from countries with public healthcare, like Canada.
  • Notable Quote:
    “People who move to the United States from other countries like Canada can go through some serious sticker shock.” — Maria Aspen (00:59)

2. Spotlight on Bartesian: A Startup's Approach

• Bartesian, a Chicago-based cocktail machine startup, offers a "no premium" health plan—employees pay nothing upfront for health insurance.
  • Medical, dental, and vision for employees (and their families) are fully covered.
  • Employees also receive a flexible $1,000 annual account to help with out-of-pocket costs.
• CEO Ryan Close attributes this approach to his Canadian background, where universal healthcare is the norm.
  • Notable Quote:
    "Really stemmed likely from being Canadian, right?... Of course I don't pay for health care." — Ryan Close (04:00)

3. The Costs and Realities of Health Insurance

• Even for small businesses, covering all premiums is a major expense that continues to rise.
  • Average annual cost to insure a family of four in the U.S.: ~$27,000 (KFF data).
  • Typical worker still pays ~$7,000/year via paycheck deductions.
  • Notable Quote:
    "Adrian, you could buy a car for that amount. You could buy one every year." — Maria Aspen (05:55)
• Most employers pass along premium costs to employees, but some cover it entirely.

4. Prevalence and Trends in "No Premium" Health Plans

• About 12% of U.S. employers offered “no premium” plans for individuals in 2025, down slightly from 2024.
• Larger companies, like Boston Consulting Group (BCG), are among those covering all premiums for employees and most family members.
  • BCG also covers plans with lower copays and deductibles.
  • Alicia Pittman (BCG HR) notes these benefits help with retention, recruiting, and workplace satisfaction.
  • Notable Quote:
    “[Offering no premiums] convinces employees to stick around longer and keeps turnover low.” — Alicia Pittman, BCG (07:25)

5. Recruitment and Retention

• No premium plans create a strong word-of-mouth recruitment pipeline and boost employee loyalty.
  • Notable Quote:
    "A lot of the hires we’ve gotten are through our current employees and team members..." — Ryan Close (07:42)

6. Important Caveats and Trade-offs

• “No premium” ≠ “free healthcare”: Employees still pay deductibles, copays, and pharmacy costs.
• Some companies shift costs—low/no premiums, but higher deductibles or copays.
• Enhanced health coverage might mean lower salaries or fewer other benefits.
• Example: Bartesian doesn’t have a formal parental leave policy, which affects some employees disproportionately (e.g., women).
  • Notable Quote:
    “Bartesian doesn't currently have a formal parental leave policy, which is a huge deal for a subset of employees and disproportionately affects women.” — Maria Aspen (08:34)

7. Sustainability and Mindset

• For some employers, once they commit to a benefit (like no premiums), they adapt and prioritize keeping it long-term.
  • Notable Quote:
    “If you start with it and you just say this is a fixed constant in our company, you adapt other things around it. It’s not that difficult.” — Ryan Close (09:15)

8. Broader Implications

• These employer-led steps aren’t a cure for the U.S. health system’s woes but provide models for what companies can control amid rising costs.
  • Notable Quote:
    “It's not a one size fits all solution. But at a time when the costs of health insurance are surging... it was kind of nice to talk some employers who are thinking about possible fixes if not for the larger healthcare system, at least for the things they can control.” — Maria Aspen (09:24)

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Notable Quotes & Memorable Moments (with Timestamps)

• On moving from Canada:
  “It's like, whoa. Like this is a wake-up call and this isn't cheap.” — Ryan Close (01:05)

• On the rising costs:
  “There has been years where we’re redoing the premiums... and there's like a slight gulp in my throat...” — Ryan Close (05:00)

• Perspective on costs:
  “You could buy a car for that amount. You could buy one every year.” — Maria Aspen (05:55)

• Team loyalty:
  “Bragging rights aside, there's also a serious return on investment for her company.” — Adrian Ma (07:25)

• Parental leave caveat:
  “Bartesian doesn't currently have a formal parental leave policy, which is a huge deal for a subset of employees and disproportionately affects women.” — Maria Aspen (08:34)

• Sustainability:
  “You adapt other things around it. It’s not that difficult.” — Ryan Close (09:15)

• Closing toast:
  “Adrian, I think I have to say it. I will drink to that. Clink.” — Maria Aspen (09:43)

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Timed Breakdown of Important Segments

| Timestamp | Segment | |-----------|------------------------------------------------------------| | 00:12 | Hosts introduce episode, highlight U.S. healthcare woes | | 02:45 | Interview with Ryan Close: Bartesian and no premium model | | 04:00 | Ryan Close on the Canadian perspective | | 05:12 | Discussion on rising premiums, ACA subsidies ending | | 06:32 | Discussion of larger companies (e.g., BCG) and benefits | | 07:25 | HR impact: retention, employee attraction | | 08:06 | Trade-offs and caveats of no premium plans | | 08:34 | Gender disparities and lack of parental leave at startups | | 09:15 | Sustainability of employee benefits | | 09:24 | Broader takeaways and closing thoughts | | 09:43 | Hosts raise a “drink” to innovative employers |

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Conclusion

This episode of The Indicator distills a complex topic into a digestible look at how some companies are countering rampant health insurance costs. By profiling both a nimble startup and a corporate giant, the hosts underline that while "no premium" health plans exist, they're not a panacea—and always come with trade-offs. Importantly, the episode highlights that employer innovation can make positive change, even if the root problems of the U.S. health system remain.

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For more insights, listen to the full episode via NPR or your favorite podcast platform.

Transcript

[Announcer]

Npr.

[Adrian Ma]

This is the indicator for Planet Money. I'm Adrian Ma, and here today, joining us is NPR financial correspondent Maria Aspen. Hey, Maria.

[Maria Aspen]

Hey there.

[Adrian Ma]

You're here because you've spent a lot of time covering the broken business of US Healthcare.

[Maria Aspen]

Yes, it is such a cheerful topic.

[Adrian Ma]

Uh huh. Well, as we know, the US has the most expensive healthcare in the developed world and the prices we pay for health insurance are getting even worse.

[Maria Aspen]

I'm actually here today though, to talk about a little bit of good news. And it starts with drinking fancy cocktails.

[Adrian Ma]

Okay, are you saying that we basically need to distract ourselves from how expensive healthcare is getting?

[Maria Aspen]

I mean, look, dealing with my insurance company can definitely make me want to drink. And I grew up with this healthcare system.

[Announcer]

System.

[Maria Aspen]

People who move to the United States from other countries like Canada can go through some serious sticker shock.

[Ryan Close]

It's like, whoa. Like this is a wake up call and this isn't cheap.

[Adrian Ma]

This is Ryan Close. He's Canadian, but he runs a Chicago startup called Bartesian. And this is where I assume the fancy drinks come in. Bartesian sells a machine that makes you cocktails at home with the push of a button.

[Maria Aspen]

But I actually talked to him because his company also has some unusually great benefits for its employees. They don't pay anything up front for health insurance. And Adrian, the really good news is he's not the only employer doing this.

[Adrian Ma]

Today on the show, how much can our employers do to make our health insurance more affordable?

[Announcer]

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[Maria Aspen]

Ryan Close and his family moved to Chicago from Ontario in 2019 to get Bartesian off the ground. It was right before the pandemic, which turned out to be great timing for a Startup that sells a machine to make cocktails at home.

[Adrian Ma]

Yeah, the Bartesian machine kind of looks like one of those Keurig or Nespresso makers. But instead of espresso, it'll make you an espresso martini. Or instead of lattes, you get mocktails and BlackBerry Mango Refreshers.

[Maria Aspen]

Bartisian sells little pods also like a Keurig. They're full of juices and other mixers. Then you can add your own booze to the machine or not press a button and it sounds like this.

[Adrian Ma]

If you've ever felt like drinking was just too much work, I guess this is the product for you.

[Maria Aspen]

Just inject that alcohol straight into your veins.

[Adrian Ma]

Well, maybe that's their next model. Artesian has had a blockbuster few years already. It's lined up some big investors like Suntory Liquor Co. Which owns Jim Beam, and Tom Ricketts, whose family owns the Chicago Cubs.

[Maria Aspen]

So as Ryan started spending that billionaire money, he decided to put a higher than usual amount towards keeping his employees healthy.

[Ryan Close]

Really stemmed likely from being Canadian, right? I would say. And where I just probably took for granted that oh, of course I don't pay for health care.

[Adrian Ma]

I guess you could take the Canadian out of Ontario, but oh, Canada. Like most employers, Bartesian negotiates with its health insurance company, but then it's offered to pay all the upfront costs or premiums instead of taking them out of their employees paychecks. We're talking medical, dental, vision insurance, plus it's for the workers and their families. The company also gives employees $1,000 every year in a flexible spending account to help with out of pocket medical costs.

[Maria Aspen]

Look, as somebody who both covers this and pays for my own employer based health insurance every year, this seems pretty great. That said, Bartesian only has about 30 employees and not all of them choose to use its health insurance. But it is still a pretty big annual expense for a small business. And it keeps going up.

[Ryan Close]

There has been years where we're redoing the premiums and renegotiating and there's like a slight gulp in my throat where I'm just like, oh wow, I remember when it was only this much. That number's getting definitely bigger.

[Adrian Ma]

And the numbers got a lot bigger last year across the board. As indicator listeners know premiums are skyrocketing for most people who get their health insurance through the Affordable Care act exchanges, also called Obamacare. That's because Congress failed to extend subsidies for those plans.

[Maria Aspen]

But that's only part of the problem because there are actually many more people in the United States who get health insurance through their employers. That's the system for the majority of working age Americans. And those premiums are also surging.

[Adrian Ma]

Altogether, they've gone up about 26% over the past five years. That's according to the health policy nonprofit KFF. So for an employer covering a family of four, that means the costs average out to about $27,000 a year.

[Maria Aspen]

Adrian, you could buy a car for that amount. You could buy one every year.

[Adrian Ma]

That's a lot of money for a

[Maria Aspen]

small business or anyone.

[Adrian Ma]

So, I mean, most employers generally make employees pay some of this through paycheck deductions, which means a worker is chipping in almost $7,000 a year on average.

[Maria Aspen]

But the thing is, employers don't have to pass along any of those costs.

[Adrian Ma]

In fact, KFF says that last year, about 12% of all employers offered some kind of no premium medical plan for individual employees. That's down a little bit from 2024, but it's still more than I was expecting.

[Maria Aspen]

I actually talked to several employers offering these kinds of no premium health insurance plans, including big companies like BO Consulting Group or bcg. Healthy employees make for a productive workforce and also a place where our teams want to come to to work every day.

[Adrian Ma]

That's Alicia Pittman. She oversees all things HR for bcg, and her company covers all insurance premiums for US employees and most of their family members, which is close to 20,000 people. So we're talking spending a lot of money here.

[Maria Aspen]

And it's spending money not only on premiums, but BCG actually also pays for insurance plans that keep other employee costs low, like the copays at the doctor's office. Alicia even told me that that's won her some points at home. My husband will say, you know, he gets a high five when he leaves the doctor's office because they look at what his co pay is and they're like, well done. You married well, yeah.

[Adrian Ma]

Bragging rights aside, there's also a serious return on investment for her company. Alicia says offering these benefits convinces employees to stick around longer and keeps turnover low.

[Maria Aspen]

It also makes it easier and cheaper to recruit new people. This is how Ryan Close from Bartesian

[Ryan Close]

put it that word spreads and a lot of the hires we've gotten are through our current employees and team members that are like, hey, I know someone who's interested in coming here.

[Adrian Ma]

Now. There are a couple of caveats. No premium health insurance isn't the same as totally free health insurance. Employees usually also have to pay for deductibles and CO pays at the doctor's office and to fill prescriptions at the pharmacy.

[Maria Aspen]

Some companies that cover all of the upfront costs basically shift expenses around. So you might not have anything taken out of your paycheck, but then you might have to pay a higher deductible or higher CO pays. If you actually need to go to the doctor or the hospital, and if

[Adrian Ma]

your employer is covering more of your health insurance costs, there might be trade offs in the rest of how you're being compensated. That might mean you're getting paid less in salary or not being offered other kinds of benefits.

[Maria Aspen]

For example, Bartesian doesn't currently have a formal parental leave policy, which is a huge deal for a subset of employees and disproportionately affects women.

[Adrian Ma]

So startups gonna start up? I guess.

[Maria Aspen]

I guess. I mean that's pretty much what Ryan told me. He has about 30 employees, so he's still running a pretty small business. And he says that he prefers dealing with parental leave requests on an ad hoc basis.

[Adrian Ma]

But Ryan did say once he starts offering a formal benefit to employees, he wants to stick with it, even if it ends up costing him more over time. Like what he's seen with the no premium health insurance plans for his workers.

[Ryan Close]

If you start with it and you make it and you just say this is a fixed constant in our company, you adapt other things around it. It's not that difficult.

[Maria Aspen]

It's not a one size fits all solution. But at a time when the costs of health insurance are surging so much for everyone, it was kind of nice to talk some employers who are thinking about possible fixes if not for the

[Adrian Ma]

larger healthcare system, at least for the things they can control.

[Maria Aspen]

Adrian, I think I have to say it. I will drink to that clink.

[Adrian Ma]

This episode was produced by Cooper Katz McKim and engineered by Kwesi Lee. It was fact checked by Sierra Juarez. Cake and Cannon is our editor and the indicators of production of npr.

[Announcer]

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