Alabama Health Insurance Premiums Said to Exceed a Typical Mortgage Payment

Health insurance premiums and out-of-pocket costs in Alabama can run to more than twice the monthly mortgage payment on an average home, according to a recent report.

A major insurer dominates Alabama’s private health insurance market and, according to an article by independent journalist and former New York Times reporter Alex Berenson published on his Unreported Truths Substack, a family of three can face annual costs of well over $50,000.

Alabama resident Cristopher Hoyt received a renewal notice for his family’s 2027 health plan from BlueCross Blue Shield showing a monthly premium of $4,287.61, Berenson reported. That was nearly 36 percent higher than the amount he paid this year.

In 2025, Hoyt paid just under $2,487 a month for coverage for his family, or about $30,000 for the year. In 2026, BlueCross BlueShield raised the rate by almost 30 percent to $3,156 a month, bringing the annual bill to nearly $38,000, Hoyt told Berenson.

That means Blue Cross Blue Shield in Alabama increased its premium costs by more than 70 percent over two years.

The new monthly payment of more than $4,000 is more than twice the average U.S. mortgage payment, and Hoyt’s in-network maximum also increased to $12,000. Berenson found that Hoyt will need to pay $51,451.32 to cover himself, his wife and their 21-year-old son for 2027.

The median monthly mortgage payment for U.S. homeowners was $2,134, according to Bankrate.

BlueCross BlueShield has an 84 percent share of Alabama’s health insurance market, the American Medical Association said.

According to the Blue Cross Blue Shield Association website, BCBSA is a national association of independent, community-based and locally operated Blue Cross Blue Shield companies that covers more than 115 million people across the United States and holds trademarks in 170 countries.

Berenson reported that because BCBSA operates as a hospital system, it is technically treated as a nonprofit, allowing it to use several price-transparency loopholes.

He also said BlueCross executives are protected from having their salaries disclosed to the public after an Alabama ruling. AL.com reported that a state law passed in 2015 hides those salaries from public view, meaning the company does not file Form 990s with the IRS.

The only other state with a similarly concentrated market is Kentucky, where Elevance Health, an arm of Blue Cross Blue Shield, controls more than 65 percent of the market, Berenson wrote.

Hoyt and his wife have an ownership stake in a successful family business and will be able to absorb the higher cost, according to Berenson.

“Whether I can afford to pay the increase or not, I still believe the system is extraordinarily broken and benefits hospitals, insurance companies, and drug companies,” Hoyt told Berenson.