Key Takeaways
- Upstream health care prices continue to grow more expensive — and this trend is showing up downstream in Michigan’s health insurance premiums.
- The imbalance between claims paid and premiums collected is driving double-digit premium increases for 2026.
- A recent article from The Detroit News features comments from experts in the health care and health insurance field regarding the impact of the claims imbalance, hospital consolidation and rising prescription drug prices, and how each affect affordability.
Based on reporting from The Detroit News (October 2025)
Upstream health care prices continue to grow more expensive — and this trend is showing up downstream in Michigan’s health insurance premiums. Reporting by Chad Livengood of The Detroit News explains that Blue Cross Blue Shield of Michigan paid nearly $100 million a day last year for members’ medical and pharmacy costs, spending $12 million more per day than the year prior. These escalating upstream costs for hospital care, medical services and drugs led BCBSM to spend more on health care claims than it collected in premiums.
The story rests behind The Detroit News’ paywall, but subscribers can access the report here.
The imbalance between claims paid and premiums collected is driving double-digit premium increases for 2026 — about 12% for small business plans and up to 18% for individuals — with similar hikes proposed by other insurers statewide. The Detroit News interviewed several Blue Cross leaders, including president and CEO Tricia Keith, about what is happening and what can be done. BCBSM leaders pointed to increased utilization of an expensive health care system, rising prescription drug prices and other factors driving the trend.
The story features comments from the head of the Small Business Association of Michigan regarding the impact of the claims imbalance and hospital consolidation on affordability. It also includes comments from a small business leader in West Michigan who shares her concerns about the affordability of health insurance. Health system executives are also quoted, providing their perspectives. One of the Blue Cross solutions spotlighted is the effort to introduce a biosimilar to the high-cost prescription drug, Humira – which saves BCBSM members about 90% per prescription.
Blue Cross continues working to slow the growth of costs through value-based payments to providers, negotiations on payment rates with hospital systems, biosimilar and generic drug adoption, and collaborations with health systems to improve quality and prevent costly hospitalizations. But as medical costs climb faster than inflation, Blue Cross leaders say the health care system must address inefficiencies and price pressures to restore long-term affordability for Michigan employers and families.
Read more from The Detroit News here.
Learn more about Blue Cross Blue Shield of Michigan’s commitment to affordability here.
