The Rising Cost of Health Care: What Union Members Should Know About Affordability and Access

Supporting the Health and Well-Being of Union Workers and Their Families

Across the United States, the cost of health care continues to rise, creating real concerns for working families, including members of the union labor community.

Recent insights shared by Elevance Health highlight an important reality: many Americans are delaying or skipping necessary medical care because of cost pressures. For union members and their families — who rely on strong health benefits negotiated through collective bargaining — understanding the forces driving health care costs is critical to protecting access to quality care.

According to Elevance Health, 36% of adults say they have skipped a doctor’s appointment within the past year due to cost concerns. When individuals delay care, smaller health issues can escalate into more serious and expensive conditions later.

For the labor community, this underscores why access to affordable health care — a core achievement of union bargaining — remains one of the most important protections for workers.

Understanding Why Health Care Costs Continue to Rise

Health insurance premiums often increase alongside the overall cost of medical care.

A common misconception is that premiums act as prepayments for future health services. In reality, premiums are contributions into a shared risk pool, similar to auto insurance. When the cost of care increases across the system, those higher costs eventually influence premium rates.

Over the past decade:

• Family health insurance premiums have increased by approximately 52%
• The United States now spends more than $5 trillion annually on health care

Two of the largest drivers of rising costs include:

Hospital care

Hospital spending increased approximately 10% in 2023 and 2024, representing the fastest growth in over 30 years.

Prescription medications

Prescription drug spending increased approximately 8% in 2024, continuing a long-term trend of rising pharmaceutical costs.

These increases ripple through the entire system, affecting employer health plans, union benefit funds, and ultimately workers.

System Challenges That Drive Higher Health Care Costs

According to Elevance Health, several structural issues contribute to rising costs within the health care system:

• System complexity across providers, insurers, and regulators
• Limited data sharing across health care organizations
• Fraud, waste, and abuse within parts of the system
• Regulatory inefficiencies that complicate care delivery

One example often discussed by health policy experts is the No Surprises Act, a federal law designed to protect patients from unexpected medical bills when they receive emergency care or treatment from out-of-network providers.

While the law was intended to protect patients, some health industry leaders note that its implementation has created an unexpected surge in billing disputes between insurers and providers.

Dr. Catherine Gaffigan, President of Health Solutions at Elevance Health, noted that federal officials initially expected approximately 17,000 disputes annually, but millions of cases have occurred nationwide since implementation. Elevated administrative costs associated with these disputes can indirectly contribute to higher premiums over time.

How Health Plans Are Working to Improve Affordability

Health organizations are increasingly exploring new strategies to control costs while maintaining quality care.

Elevance Health highlights three key approaches being implemented across parts of the health system.

1. Aligning Coverage with Cost and Outcomes

Health plans are increasingly evaluating where medical services are delivered and whether more affordable settings can provide the same outcomes.

Research cited by Elevance Health found that non-oncology infusion therapies performed in hospital outpatient departments cost approximately 42% more than identical treatments in alternative care settings, while patient outcomes remained comparable.

By encouraging care in high-quality but lower-cost settings, health plans can help reduce overall spending without compromising patient care.

2. Improving Coordination Across the Health System

Better communication between insurers, providers, and regulators can help identify fraud, waste, and abuse in health programs.

An Elevance Health-supported analysis found that Medicare could have saved approximately $7 billion over five years on services vulnerable to fraud if safeguards similar to those used in Medicare Advantage programs had been applied.

Improved coordination across the system helps reduce unnecessary spending while ensuring patients receive appropriate care.

3. Expanding the Focus Beyond Traditional Medical Care

Health outcomes are influenced by more than clinical treatment.

Factors such as:

• access to healthy food
• stable housing
• mental health support
• social and economic conditions

play a significant role in long-term health outcomes.

Health plans increasingly use data and preventive care strategies to identify barriers earlier and connect individuals with resources before medical conditions worsen.

Why This Matters for Union Members and Benefit Funds

For generations, union contracts have helped secure high-quality health benefits for workers and their families. These negotiated plans remain one of the most important protections for working people.

However, rising health care costs impact:

• union health and welfare funds
• employer contributions
• contract negotiations
• long-term sustainability of benefit plans

That is why collaboration across the entire health care system — insurers, providers, policymakers, and employers — is necessary to address affordability challenges.

Solutions discussed by policy experts often include:

• improved price transparency in hospital services
• greater data sharing across health systems
• reforms that reduce fraud and administrative inefficiencies
• policies that ensure laws like the No Surprises Act function as intended

A Shared Responsibility to Improve Health Care Affordability

Addressing the rising cost of health care requires cooperation across multiple sectors.

Health plans such as Elevance Health, policymakers, hospitals, and regulators all play a role in developing solutions that reduce costs while protecting quality care.

For the union labor community, protecting access to affordable health care remains essential to supporting workers, families, and the communities they serve.

Strong benefit plans, responsible system reforms, and collaborative solutions can help ensure that working families continue to receive the care they need without facing financial hardship.

About the ULA Network

The Union Labor Advisory Network (ULA Network) is dedicated to supporting, educating, and promoting union labor and the communities union members serve. Through educational media, workforce development storytelling, and partnerships with labor organizations and industry leaders, the ULA Network works to highlight the value of union careers and the resources that support workers and their families.

Sources and Credits

This article includes information derived from insights and research shared by Elevance Health and supporting industry analyses.

Referenced materials include:

• Elevance Health affordability and health system insights
• “Infusion therapy patient outcomes are similar at reduced costs in alternative sites of care compared with hospital outpatient departments.”
• “Medicare Could Have Saved $7.0 Billion in Spending on Select Services Subject to Fraud, Waste, and Abuse if Medicare Advantage techniques had been employed.”
• Research on arbitration outcomes under the No Surprises Act.

Information has been summarized and adapted for educational purposes by the ULA Network. Content in this article has been summarized and rewritten for educational and informational purposes in accordance with fair use guidelines.