2025 年健康保險產業統計：覆蓋範圍、成本與創新

健康保險已成為美國財務安全的基石，幫助個人應對不斷上漲的醫療費用。

The health insurance industry in the United States is a vast and complex ecosystem, influenced by a multitude of factors ranging from technological advancements and regulatory changes to shifting demographics and economic trends. These statistics, updated as of January 10, 2025, provide a snapshot of the industry's landscape, highlighting key aspects such as coverage, enrollment, gross written premium, market share, premium trends, demographic and regional insights, global dynamics, Medicare Advantage and public health exchange markets, and recent developments.

美國的健康保險產業是一個龐大且複雜的生態系統，受到技術進步、監管變化、人口結構和經濟趨勢變化等多種因素的影響。這些統計數據截至2025 年1 月10 日更新，提供了行業概況的快照，突出顯示了覆蓋範圍、註冊人數、總承保保費、市場份額、保費趨勢、人口和區域洞察、全球動態、醫療保險優勢和公共等關鍵面向。

Editor's Choice: Key Health Insurance Statistics As of 2025

編輯精選：截至 2025 年的主要健康保險統計數據

In 2025, the total number of people covered by health insurance in the United States reached approximately 338.3 million, out of which 312.9 million had private health insurance and 25.4 million were covered by Medicaid.

2025年，美國醫療保險覆蓋總人數約3.383億，其中3.129億人擁有私人健康保險，2,540萬人享有醫療補助。

The gross written premium for the health insurance industry in the United States amounted to $1.6 trillion in 2025.

2025年，美國健康保險業的總承保保費將達到1.6兆美元。

UnitedHealth Group maintained its dominance in the health insurance market, holding a market share of 14.1% in 2025, followed by Anthem, Inc. at 8.9% and CVS Health at 8.1%.

UnitedHealth Group 繼續保持其在健康保險市場的主導地位，2025 年市佔率為 14.1%，其次是 Anthem, Inc.（8.9%）和 CVS Health（8.1%）。

Between 2020 and 2025, health insurance premiums experienced a rise, with an average annual increase of 4.5%.

2020年至2025年，健康保險保費呈上升趨勢，年均上漲4.5%。

The health insurance industry in the United States is expected to continue expanding, driven by factors such as increasing demand for health services, technological advancements, and regulatory changes.

在健康服務需求增加、技術進步和監管變化等因素的推動下，美國的健康保險業預計將繼續擴張。

The health insurance industry in the United States is a heavily regulated sector, with both state and federal agencies playing a role in overseeing the industry. At the federal level, the Department of Health and Human Services (HHS) has primary responsibility for regulating health insurance, through agencies such as the Centers for Medicare & Medicaid Services (CMS) and the National Association of Insurance Commissioners (NAIC). State insurance departments also have significant authority over the industry within their respective jurisdictions.

美國的健康保險業是一個受到嚴格監管的行業，州和聯邦機構都在監督該行業方面發揮作用。在聯邦層面，衛生與公眾服務部 (HHS) 主要負責透過醫療保險和醫療補助服務中心 (CMS) 以及全國保險專員協會 (NAIC) 等機構監管健康保險。國家保險部門在各自管轄範圍內對該行業也擁有重要的權力。

Health insurance regulations in the United States cover a wide range of topics, including licensing and solvency requirements for insurers, premium rate setting, coverage mandates, and consumer protections. These regulations are designed to ensure that health insurers are financially sound, that premiums are fair and reasonable, and that consumers have access to affordable and comprehensive health coverage.

美國的健康保險法規涵蓋廣泛的主題，包括保險公司的許可和償付能力要求、保險費率設定、保險範圍要求和消費者保護。這些法規旨在確保健康保險公司財務穩健，保費公平合理，並確保消費者能夠獲得負擔得起的全面健康保險。

Over the years, there have been numerous debates and discussions regarding the optimal level of government regulation in the health insurance industry. Some argue that greater regulation is needed to protect consumers and ensure the industry operates in the public interest, while others contend that excessive regulation stifles innovation and drives up costs. The ongoing discussions and varying perspectives on this topic reflect the complexity and importance of finding the right balance in regulating the health insurance sector.

多年來，關於健康保險業的政府監管最佳水平存在著無數的爭論和討論。有些人認為，需要加強監管以保護消費者並確保該行業的營運符合公共利益，而另一些人則認為過度監管會扼殺創新並推高成本。關於這一主題的持續討論和不同觀點反映了在健康保險行業監管中找到適當平衡的複雜性和重要性。