Health insurance premiums are on the rise across the globe, with recent developments in Saudi Arabia, New York, and Arizona highlighting both the opportunities and the challenges facing consumers and insurers alike. As governments and regulators grapple with medical inflation, changing demographics, and evolving policy landscapes, millions are bracing for higher costs, while industry leaders look to innovation and regulatory reform as levers for sustainable growth.
In Saudi Arabia, the insurance sector is poised for what analysts are calling unprecedented expansion. According to the Saudi Insurance Sector Review 2024 by Bupa Arabia for Cooperative Insurance, gross written premiums (GWP) are projected to surge from SAR75.9 billion in 2024 to over SAR129 billion by 2030. Health insurance, which already constitutes 55 percent of the market, is expected to nearly double its premiums—from SAR42 billion to SAR83 billion over the same period. This remarkable growth is attributed to a confluence of factors: regulatory reforms, digital transformation, massive investments under Vision 2030, and an expanding base of insured individuals.
The scale of change in Saudi Arabia’s insurance market is striking. As reported by Bupa Arabia, the sector has more than tripled in size over the past decade, climbing from SAR21.3 billion in 2012 to SAR75.9 billion in 2024. Much of this growth accelerated in the wake of the COVID-19 pandemic, which forced insurers to embrace digital platforms and innovative regulatory solutions such as the InsurTech Sandbox, the Nafis platform, and the "Virtual Hospital." These tools enabled the market to weather the crisis and achieve a compound annual growth rate of 22 percent.
But what’s fueling this momentum? Vision 2030, the Saudi government’s sweeping modernization initiative, stands at the center. Channeling over SAR1 trillion into healthcare, infrastructure, and technological upgrades, Vision 2030 has created vast new opportunities for insurers. Connected medicine—think telehealth and remote care—is emerging as a game changer, expanding access, reducing costs, and improving patient experiences. "The Saudi health insurance market is experiencing substantial expansion driven by Vision 2030, which has laid a solid foundation for growth. The combination of strict regulations and effective supervision ensures that this momentum translates into sustainable growth, while digital transformation opens vast opportunities to innovate and enhance customer services," said Nadeem Shahzad, director of customer and market insights at Bupa Arabia, as cited in the review.
Regulatory changes are also reshaping the landscape. New rules expanding mandatory coverage to domestic workers and gig economy participants could add SAR9.4 billion in GWP. Meanwhile, Saudi Arabia’s ambitious tourism targets—aiming for 150 million annual visitors by 2030, up from just over 100 million in 2023—are expected to generate another SAR4.5 billion in insurance premiums. Mega-projects in Riyadh, such as Mall of Saudi, The New Murabba, and King Salman Energy City, are further boosting demand for insurance products, positioning the capital as the sector’s new growth hub.
Yet, it’s not all smooth sailing. The report warns that medical inflation, driven by expanded benefits and reliance on advanced technologies, is outpacing global averages and straining insurers’ ability to control costs. "Medical data has become the new currency of the healthcare era. It is the foundation for developing more accurate and effective services. Value-based care remains the best way to address medical inflation challenges and improve service quality, ensuring the sector’s sustainability and maximizing its contribution to the national economy," Shahzad added. Other hurdles include regulatory compliance gaps—some private sector workers and their families remain uninsured—and the struggle of smaller companies to keep up with digital transformation, potentially consolidating market power among larger players.
Despite these headwinds, the Saudi insurance market has shown remarkable resilience. After absorbing the shocks of VAT implementation and dependent fees in 2020–2021, the number of insured individuals hit a record 12.1 million in 2023, rising to 13.2 million in 2024. Expanding coverage to include domestic workers, tourists, and gig economy employees is seen as a key opportunity to drive further growth and inclusivity.
Looking ahead, advanced statistical modeling suggests two main scenarios for health insurance in Saudi Arabia. In the baseline scenario, the number of insured individuals is expected to reach about 15 million by 2030, with health premiums hitting SAR65.2 billion. Should regulators expand mandatory coverage even further, premiums could soar to SAR83 billion, strengthening the healthcare system and broadening access.
While Saudi Arabia’s market is booming, consumers in the United States are bracing for a different kind of change—one marked by rising costs and shrinking subsidies. In New York, state regulators have approved health insurance premium increases for 2026, impacting thousands of families and businesses. According to WIBX 950, insurers such as Excellus Health Plan, Highmark Western and Northeastern New York, and Independent Health had initially requested rate hikes ranging from 20 percent to more than 38 percent. After regulatory review, those increases were trimmed, but premiums will still rise by an average of 7 to 13 percent. The New York State Department of Financial Services said it considered medical cost trends, prescription drug prices, and insurers’ financial stability in its decision.
For New Yorkers, the upshot is clear: health insurance is about to get more expensive, even as household budgets are already stretched by the rising cost of everyday necessities. As WIBX 950 put it, "Even with the state’s cuts to the original proposals, many families will be digging deeper into their wallets to stay covered in 2026. Health care isn’t getting cheaper—and this latest decision proves it."
In Arizona, the sticker shock is set to be even more severe. The Arizona Department of Insurance and Financial Institutions has warned that insurers are proposing premium increases for Affordable Care Act (ACA) marketplace plans ranging from about 2.5 percent to a staggering 55.3 percent for 2026. The real pain, however, will come from the expiration of federal tax credits that have until now offset much of the monthly cost for consumers. Matt McGough, a policy analyst at KFF, told KJZZ, "They certainly are going to experience a price shock for how much more they're going to have to pay for their health insurance premiums on a monthly basis." Most enrollees could see their monthly payments rise by as much as 90 percent once the subsidies disappear.
Why the steep increases? Insurers expect that as premiums climb, younger and healthier consumers will drop coverage, leaving a sicker, costlier pool of enrollees. Rising health care costs, including tariffs on pharmaceuticals and medical devices, are also fueling the hikes. "Most enrollees will be facing a double whammy of higher insurance bills and losing a subsidy that lowers much of that monthly cost for them," McGough explained. For small-business owners and gig workers who rely on ACA plans, the options may be limited. "Unfortunately, the reality is that some people will be left with no good option," he added. Arizona’s insurance regulator is advising consumers to shop around when open enrollment begins on November 1.
Across these diverse markets, one thing is clear: health insurance is evolving rapidly, shaped by economic forces, policy changes, and technological innovation. Whether it’s the promise of expanded coverage and digital transformation in Saudi Arabia, or the hard realities of rate hikes and subsidy cuts in the U.S., the coming years will test the resilience of insurers and the budgets of millions of families. As the sector matures and adapts, the challenge will be finding ways to balance affordability, access, and sustainability in an increasingly complex world.
