Part 2: Understanding US Healthcare Affordability: Increasing Plan Complexity Must be Met With Better Cost Estimate Data

Regulatory changes between 2024 and 2025 lowered out-of-pocket maximums in many states, which in theory makes care more affordable. In our eligibility dataset, we see that average out-of-pocket maximums dropped 36.8%, from $7,788 to $4,926. Coinsurance rates decreased 6.2%, from 16.5% to 15.5%. Both reductions should have lowered what patients pay