Imagine facing skyrocketing health insurance bills that could eat into your hard-earned paycheck—it's a reality hitting millions of Americans right now, but what if your job could shield you completely from that burden? Stick around to discover how some forward-thinking companies are stepping up in a big way.
NPR's ongoing series, Cost of Living: The Price We Pay (https://www.npr.org/series/g-s1-89066/cost-of-living), dives deep into the factors fueling these relentless price hikes and explores the real-life strategies people are using to manage in the wake of prolonged inflation. Curious about how escalating costs are reshaping your daily routine? We invite you to share your experiences by completing this quick form (https://www.npr.org/2025/09/12/g-s1-88442/cost-of-living-prices) so NPR can feature stories like yours.
What's at the heart of this issue?
Health care
How have costs evolved since the pre-pandemic era?
In the United States, health care stands out as the priciest system among all developed nations, and unfortunately, the situation is deteriorating further. Last year, the typical yearly premium for an employer-sponsored health plan covering a family of four exceeded $25,500, based on data from the nonprofit health policy organization KFF (https://www.kff.org/interactive/premiums-and-worker-contributions-among-workers-covered-by-employer-sponsored-coverage-1999-2024/). Breaking it down, employers shouldered around $19,200 of that amount, while employees chipped in approximately $6,300 through payroll deductions. For beginners navigating this, premiums are essentially the monthly or annual fees you pay to have insurance coverage in the first place—think of it as the entry ticket to accessing medical services without facing ruinous out-of-pocket expenses.
Since 2019, these total premiums have climbed by over 24%, and experts predict even steeper increases ahead (https://www.npr.org/2025/09/12/nx-s1-5534416/health-care-costs-soaring-blame-your-employer) for the coming year. And this is the part most people miss: while inflation has cooled in other areas, health care costs keep surging unchecked, putting extra pressure on family budgets already stretched thin.
What’s fueling these price jumps?
A network of profit-driven enterprises—ranging from pharmaceutical giants and pharmacy benefit managers to hospitals and insurers—has been instrumental in inflating the price of medical services across the U.S. (https://www.npr.org/2025/09/12/nx-s1-5534416/health-care-costs-soaring-blame-your-employer).
Pharmaceutical companies are innovating with groundbreaking treatments, such as GLP-1 drugs that aid in weight loss (like those mimicking hormones to curb appetite and improve blood sugar control) and advanced cancer therapies. However, these advancements come with hefty price tags that make them tough for many to afford. Post-pandemic, there's been a rush back to doctor's offices as people catch up on delayed care, which has spiked demand and, in turn, driven up fees—for instance, routine check-ups that were once affordable now often carry surprise add-ons. Moreover, a wave of mergers and consolidations among insurance providers (https://www.npr.org/2024/12/12/nx-s1-5224157/health-care-occupy-wall-street-moment) and other health care entities (https://www.npr.org/2024/12/20/nx-s1-5234682/big-health-care-terrible-year-business-of-health) has reduced competition, enabling the surviving players to hike their rates more freely (https://www.kff.org/health-costs/ten-things-to-know-about-consolidation-in-health-care-provider-markets/). To clarify for newcomers, consolidation means fewer companies controlling the market, which can limit choices and bargaining power for consumers, much like how fewer airlines on a route might mean higher ticket prices.
But here's where it gets controversial: is it fair to pin the blame solely on these businesses, or do deeper systemic issues like outdated regulations play a role too? We'll circle back to that.
An unexpected lifeline for certain American workers
Roughly 154 million folks in the U.S. rely on employer-provided health insurance (https://www.kff.org/state-health-policy-data/state-indicator/health-insurance-coverage-population-0-64/?dataView=1¤tTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D), and for many, that could translate to payroll deductions jumping by 6% to 7% on average next year (https://www.mercer.com/en-us/insights/us-health-news/employers-prepare-for-the-highest-health-benefit-cost-increase-in-15-years/).
While bosses have limited sway over the overall premium rates set by insurers, they hold the reins on how much of that burden shifts to employees. Nationwide, a growing number of organizations—both giants and local outfits—are opting to absorb the full cost themselves, sparing workers any upfront premium payments from their salaries.
Take Boston Consulting Group (BCG), for instance: this global firm foots the entire bill for health insurance premiums for its about 10,000 American staffers and their loved ones, ensuring zero deductions hit those paychecks for coverage basics.
"A thriving team leads to higher productivity and creates an environment where people genuinely look forward to showing up each day," explains Alicia Pittman, BCG's chief people officer.
All told, BCG is bankrolling complete coverage for nearly 20,000 individuals when including family members—a substantial financial commitment, as Pittman notes, though she keeps the exact figure under wraps.
Yet, leaders like her emphasize to NPR that such generosity yields significant returns for the business. By eliminating premium costs, companies like BCG find it simpler to attract top talent and minimize staff churn, which can be costly—replacing an employee often runs into thousands of dollars in recruitment and training alone. Plus, it lets workers concentrate on their roles without the nagging worry of health care bills or the hassle of dealing with a convoluted system that can feel like a maze to navigate.
Even modest-sized companies and nonprofit groups are joining the zero-premium trend
While it's not the norm, fully covering premiums isn't entirely unprecedented. Benefits experts at Mercer report that around 12% of major employers provide at least one health plan option where individual employees pay nothing upfront for coverage. (That drops to just 2% when it comes to including dependents at no extra premium cost.)
This perk extends beyond large corporate players; NPR's recent chats with leaders and staff at various organizations reveal that nonprofits, boutique businesses, and even emerging startups are adopting similar approaches.
"Access to quality health care is an absolute must-have," asserts Oliver Kharraz, CEO of Zocdoc, a platform that simplifies booking virtual or in-person doctor visits online, much like how apps make reserving a dinner table effortless.
Of course, health care expenses in America go far beyond premiums alone—for example, many plans with low or no premiums offset that by imposing steep deductibles (the amount you pay out-of-pocket before insurance kicks in, say $2,000 or more annually) or copays (small fees per visit, like $20–$50). It's a trade-off that can catch people off guard if they're not prepared.
Zocdoc doesn't shoulder every single expense; it presents a menu of plans, and opting for the no-premium choice means tackling a larger deductible. That said, the company sweetens the deal by contributing to employees' health savings accounts (tax-advantaged funds for medical costs) to ease some of that load.
"Sure, it's an escalating outlay for us," Kharraz acknowledges, "but we view it as part of our responsibility to keep the business robust enough to handle these priorities."
This commitment resonated deeply with startup entrepreneur Ryan Close, who made it a cornerstone of his company's culture from day one. Back in 2019, Close relocated from Canada to Chicago with his family, only to encounter a shocking reality when a simple prescription filled after someone fell ill.
"It hit me like a ton of bricks: 'Wow, this is eye-opening—and way more expensive than I imagined,'" he recalls.
Today, as founder and CEO of Bartesian, a Chicago-based innovator in at-home cocktail makers (think pod-based systems akin to single-serve coffee machines, but for mixed drinks), Close is channeling resources into his team's well-being. The firm, which has exploded in popularity since the pandemic and secured $40 million in funding from backers like Chicago Cubs owner Tom Ricketts and Suntory (the powerhouse behind Jim Beam), now fully covers medical, dental, and vision premiums for all 30 employees and their families. On top of that, Bartesian adds $1,000 yearly to their flexible spending accounts, which help with everyday health expenses like over-the-counter meds.
Naturally, there are compromises: as Bartesian expands amid rising health costs, expenses climb, and the company skips certain standard perks, such as structured parental leave programs that allow new parents time off with pay.
Still, Close is convinced that this health-focused strategy has streamlined hiring skilled professionals and fueled sustainable growth, especially in a competitive job market where benefits can make or break a candidate's decision.
"It's a clear signal of our values and how much we cherish our people," he shares.
"Prioritizing their ability to care for kids, spouses, and partners? That's non-negotiable for us," he continues.
Close's drive boils down to a straightforward personal insight.
"It all traces back to my Canadian roots," he admits. "I grew up assuming health care was just a given—no bills to worry about. Coming here was a real adjustment."
But here's a controversial angle to ponder: while these employer perks sound ideal, could they inadvertently widen inequality by making health coverage a privilege tied to your job rather than a universal right? In a country where 28 million remain uninsured, is this patchwork approach enough, or does it highlight the need for bolder reforms like a single-payer system? What do you think—should more companies follow suit, or is government intervention the real fix? Drop your thoughts in the comments below; we'd love to hear if you've experienced something similar or have strong opinions on this debate!
