Podcast Summary: Today, Explained — “Why your health insurance is so expensive” (November 9, 2025)

Overview

In this episode of Today, Explained, host Jonathan “JQ” Hill, along with expert guests Lisa Jarvis (Bloomberg), Julie Rovner (KFF Health News), and Dylan Scott (Vox), break down why health insurance premiums are rising in 2025 and demystify the confusing process of choosing a health plan. The episode explores the core drivers behind higher costs, the complexities of health insurance jargon, and the alternatives some Americans are seeking—including the risks and realities of cost-sharing ministries. The conversation maintains a conversational, sometimes wry tone, reflecting the frustration and confusion many Americans feel about navigating the current system.

Key Discussion Points & Insights

Choosing a Health Insurance Plan: Decoding the Jargon

• Start by assessing your needs: Lisa Jarvis recommends analyzing your current healthcare usage (e.g., regular prescriptions, provider preferences, upcoming medical needs) before choosing a plan ([02:19] Lisa Jarvis).
  • HMO vs. PPO:
    • HMO: Cheaper, limited provider network, requires primary care provider and referrals for specialists.
    • PPO: More flexibility, higher cost, allows out-of-network visits, generally does not require referrals.
  • "With an HMO, you're going to have to pick a primary care provider... The PPO is going to give you a lot more flexibility, and so it probably is going to be more expensive. And you'll feel that." ([03:41] Lisa Jarvis)
• Jargon demystified ([04:14] Lisa Jarvis):
  • Premium: Amount deducted from your paycheck.
  • Deductible: How much you pay before insurance coverage starts.
  • Copay: Fixed amount per doctor or specialist visit.
• High-Deductible Plans & Accounts:
  • High-deductible plans may be best for people who rarely visit the doctor, offering low premiums but high out-of-pocket costs before coverage kicks in.
  • HSA (Health Savings Account): Only for high-deductible plans, contributions are pre-tax, roll over year-to-year, can be invested.
  • FSA (Flexible Spending Account): Employer-sponsored, must use funds by year’s end (with small exceptions).
  • "You have to have a high deductible plan...That money can roll over for year to year and it can also grow so it can be invested." ([05:43] Lisa Jarvis)

The Confusing Maze of Health Insurance

• Even the experts get puzzled: Both hosts and guests emphasize how confusing insurance decisions can be, highlighting a lack of clear, accessible guidance from employers and insurers.
  • "It can be a really—it's like trigonometry and algebra and geometry combined." ([07:48] Lisa Jarvis)
  • "This whole process seems like it can be so confusing. Do you find it confusing?" ([07:18] Jonathan (JQ) Hill)
• Be vigilant this year: Rising costs mean old plans may not be the best fits; check the fine print and don't just renew by default.
  • "This is the year to not just accept the plan that you've had every year and just weigh your options carefully." ([08:44] Lisa Jarvis)

Why Are Premiums Rising in 2025?

• Premiums are rising across all coverage types ([11:43] Julie Rovner).
  • "Health care costs have been rising, but not terribly fast. They seem to be accelerating again now."
• Two Main Drivers ([12:04] Julie Rovner):
  1. Utilization:
     • Aging population: Baby boomers need more healthcare as they age.
     • Post-pandemic catch-up: People deferred care during COVID, are now seeking more services—sometimes for worsened conditions.
     • New treatments: Advances in drugs (e.g., weight loss drugs), and less invasive surgeries drive up overall usage.
  2. Price:
     • "We have the highest prices in the world because people who provide health care here can." The U.S. lacks serious price regulation compared to most other wealthy nations.

Systemic Factors & Subsidies

• Government subsidies are broader than many realize:
  • Medicare, Medicaid, and employer-provided plans are subsidized, not just ACA (Obamacare) coverage.
  • "There's a gigantic tax break for people who have employer provided coverage that most people aren't even aware of." ([17:53] Julie Rovner)
• ACA Premium Increases ([15:01] Julie Rovner):
  • Insurers anticipate the end of pandemic-era subsidies, which will change who remains in the ACA market (sicker people more likely to stay, prompting higher premiums to offset risk).
  • Workers might see more costs shifted to them as the labor market softens and employers choose not to further absorb higher costs.

The Impact on Consumers—and What You Can Do

• Transparency can help, but not cure:
  • Price transparency and price shopping might help reduce costs, but “we’re all sort of captives of the mess of a healthcare system that we have right now.” ([16:37] Julie Rovner)
  • Some savings may be found by paying cash, especially for generic drugs or outpatient procedures.
• Out-of-pocket costs soar: Even those with good insurance face growing co-pays and deductibles, raising the risk of uninsurance as people drop coverage due to cost ([18:28] Julie Rovner).

Alternatives & “Creative” Solutions: Cost Sharing Ministries

• GoFundMe as a last resort and cost sharing ministries as an alternative:
  • “You see people going to GoFundMe or Kickstarter just literally basically begging people like, please help me with my medical costs.” ([21:06] Dylan Scott)
  • Cost Sharing Ministries: Groups (often religiously affiliated, but becoming more secularized over time) where members pool funds to cover each other's medical bills—exempt from insurance regulations.
    • Enrollment has exploded to roughly 1.7 million Americans as of 2023 ([25:05] Dylan Scott).
  • Pitfalls:
    • No regulatory protections for pre-existing conditions, benefit caps, or solvency.
    • “You're basically just relying on the goodwill of these ministries to pay out and just hoping that they have enough money to cover whatever your medical bills may be.” ([25:58] Dylan Scott)
• Scaling up is not the answer: These ministries cannot substitute for comprehensive, regulated insurance.

The Larger Problem—and Hopes for Solutions

• The system remains fundamentally broken: Americans are forced into individualistic, consumerist choices in a system that punishes risk and serious illness.
• Ultimately, the solution must involve reducing system-wide costs through policy change, industry collaboration, and comprehensive overhaul—not sidestepping the insurance system.
  • "In the long term, we need policymakers and the industry and the payers to come together and figure out how to make just the overall costs of healthcare lower so that we can provide people with comprehensive coverage more affordably." ([27:52] Dylan Scott)

Notable Quotes & Memorable Moments

• On choosing plans:
  "I would say the first thing to think about is how you use your healthcare... Are you going to the doctor regularly? Do you have prescriptions that you take regularly?" – Lisa Jarvis ([02:19])

• The reality of confusion:
  "It can be a really—it's like trigonometry and algebra and geometry combined. I don't know, trying to calculate all the right factors and come up with the right choice." – Lisa Jarvis ([07:48])

• On why U.S. prices stay high:
  "We have the highest prices in the world because people who provide health care here can. The government doesn't regulate it nearly as much as they do in other countries." – Julie Rovner ([13:37])

• Reflections on consumer burden:
  "We're all sort of captives of the mess of a health care system that we have right now." – Julie Rovner ([16:37])

• On cost-sharing alternatives:
  "You're basically just relying on the goodwill of these ministries to pay out and just hoping that they have enough money to cover whatever your medical bills may be." – Dylan Scott ([25:58])

• On long-term fixes:
  "[We need to] figure out how to make just the overall costs of healthcare lower so that we can provide people with comprehensive coverage more affordably." – Dylan Scott ([27:52])

Timestamps for Key Segments

• [02:19 – 06:54]: Plan types, premiums, deductibles, copays, FSA/HSA explained (Lisa Jarvis)
• [07:00 – 09:05]: The confusion of open enrollment
• [11:23 – 16:29]: Why premiums are rising; impact of aging, pandemic catch-up (Julie Rovner)
• [17:30 – 19:19]: Systemic issues, government subsidies, and risks of dropping coverage
• [20:30 – 27:52]: The search for alternatives (GoFundMe, cost-sharing ministries); their risks and limitations (Dylan Scott)
• [27:49 – 28:41]: What’s really needed: system-wide cost control and policy solutions

Conclusion

This episode delivers a sobering, accessible look at the rising costs of health insurance in America, clarifies confusing plan mechanics, and exposes the hard trade-offs facing consumers. The hosts and guests balance humor, frustration, and expertise to convey the urgency—and complexity—of managing health costs in 2025. For listeners, the takeaways are clear: scrutinize your options, understand what you’re really paying for, and know that, for now, systemic change is still elusive.