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You’re probably paying more for insurance lately. A new study suggests federal action to cut costs

WASHINGTON (AP) — A new analysis suggests Americans are being overcharged by $150 billion annually to insure their homes, autos and businesses — and it proposes federal guardrails so that a public beset by affordability pressures could see savings.

The analysis by the Vanderbilt Policy Accelerator obtained exclusively by The Associated Press details how insurers are paying out less on claims after an accident, natural disaster or other misfortune than they did decades ago. For every $1 collected in premiums, insurers reimbursed 62 cents for claims in 2024, down from an average loss ratio of 80 cents in the 1980s and 1990s.

The analysis wades into a thorny set of economic and political questions as insurance companies are managing the potential risks of climate change when the cost of groceries, gasoline and housing are a frustration for many voters. Insurance companies say they have hiked premiums because of rising prices for homes and autos and the expenses of fixing them.

“The fact that the loss ratios are so low means that the insurance industry is charging too much,” said Brian Shearer, director of competition and regulatory policy at the Vanderbilt University think tank and a former senior adviser at the Consumer Financial Protection Bureau.

The insurance industry said its current loss ratio reflects the costs for insurers in recent years and the steps deemed necessary for ensuring that insurance funding is stable and solvent.

“Current loss ratios reflect the impact of enormous financial losses over the last several years and the steps insurers have taken (to) maintain and restore financial strength so funds are available to pay future claims,” Don Griffin, vice president for policy and research at the American Property Casualty Insurance Association, said in an emailed statement. “Loss ratios in the 1990s were driven to nearly unsustainable levels by Hurricane Andrew in particular.”

After reviewing the analysis, Griffin added in a statement that the “state-based regulatory system is best suited” for overseeing the insurance industry as opposed to the federal guidelines in the report. He also said that mandates on loss ratios would harm customers.

“We have seen what happens when government limits insurers’ ability to appropriately price policies: markets deteriorate and policyholders are left with fewer options for coverage at higher prices,” he said.

While President Donald Trump won a second term on the promise to contain inflation, he has also gutted institutions such as the CFPB that sought to find potential savings. Housing costs have been particularly acute. Average mortgage rates remain above 6%, and an executive order by Trump to increase construction of new homes would still take years to bend the curve on housing prices.

When Trump, a Republican, signed the order on housing regulations in March, he emphasized that he was eliminating the heightened standards to protect homes against damage from natural disasters and improving energy efficiency because he said they were increasing construction costs.

“We will slash many of these pointless regulations that do nothing for safety and add lots of costs,” he said at the signing.

Research by the economists Benjamin Keys and Philip Mulder found that average premiums for home insurance climbed an inflation-adjusted 28% between 2017 and 2024 to an annual cost of $2,750. Their research found reasons for the increases: Roughly a third came from higher construction costs, and another 20% came from greater disaster risks. But it also noted the higher costs for financial instruments such as reinsurance, which insurers purchase to protect them from catastrophic financial losses.

The Vanderbilt analysis by contrast looks at the gap between what insurers charge and what they pay out to customers. By returning to the loss ratio of 80 cents paid out for each $1 collected, it estimates that households and businesses could have saved roughly $150 billion from the $1 trillion-plus paid in premiums in 2024.

The analysis includes proposed legislative language for the federal government to set a higher loss ratio for insurers. Currently, state governments primarily regulate insurance, but a federal mandate would be harder for companies to challenge.

The analysis further argues that insurers are using the premiums “to pay for corporate perks, corporate jets, stock-buy backs, excessive executive compensation, excessive dividends, excessive advertising, and excessive agent commissions.”

“Companies are competing against each other, not based on price but just based on brand awareness,” said Shearer, the author of the analysis, arguing that too much money is spent on marketing.

When you have advanced prostate cancer: What living with the disease looks like

(CNN) — “How long do I have to live ?”When I tell a patient he has prostate cancer, this is usually what he asks me first.With early-stage or low-grade prostate cancer, I can offer strong reassurance: Your life expectancy is good — expect a five-year relative survival rate of greater than 99% with treatment. Simply put, most men will not die from low-grade prostate cancer.However, once the cancer has spread outside the prostate to the bones and other organs the answer becomes more difficult. Treatment has changed dramatically over the past decade for advanced prostate cancer. New drugs, better imaging and the earlier use of combined therapies are helping men live longer.In a video released July 15, former President Joe Biden gave an update on his prostate cancer, saying he was receiving treatments that have been going well. In May 2025, Biden officially announced that he had an aggressive form of prostate cancer that had spread to his bones. Since then, based on official updates, he has continued hormone therapy, completed a course of radiation and maintained a public presence.His diagnosis brought renewed attention to prostate cancer screening and treatment. Now, more than a year later, his cancer journey offers an opportunity to examine what has changed in the treatment of advanced prostate cancer — and the hope these offer men living with the disease.I recently saw a patient who was diagnosed three years ago with cancer that had already spread to multiple areas in his bones. Since then, he has taken cruises, traveled with his family and spent weekends babysitting his grandchildren.He gets tired and cannot garden the way he once did. But he is still alive and considers every day a blessing. His experience, and what we see with Biden, shows what living with metastatic prostate cancer can look like today.Understanding survival ratesIf they haven’t asked their doctor already, many patients go online and find five-year survival rates, but every number they may find online comes with a huge asterisk.The American Cancer Society reports five-year relative survival of greater than 99% when prostate cancer is found in or near the prostate. The figure drops to 38% when it has reached distant parts of the body.But that number is based on large groups of men treated years ago. It does not fully reflect the impact of newer treatments — or account for an individual man’s age, overall health and response to therapy.Survival statistics describe groups of patients but do not predict what will happen to one person. That is why the 38% figure cannot tell us how long Biden — or any individual patient — will live. These patients’ outlook depends on details of their cancer and how they are responding to treatments.It’s treated more aggressively nowA man diagnosed with metastatic prostate cancer a decade ago and a man diagnosed today would not receive the same treatment. The thinking now is to use our best treatments early instead of holding back.For years, doctors began with hormone therapy — usually injections that lower testosterone — and saved other treatments until the cancer stopped responding.Today, those injections are often combined from the start with a newer hormone-blocking drug and/or chemotherapy. These combinations have helped men live longer and are one of the biggest shifts of the past decade.What Biden’s diagnosis told usThere are three details about Biden’s cancer that help doctors like me understand how aggressive it is and how to manage it effectively. Official statements highlighted that his cancer had a Gleason score of 9. The cancer had spread to his bones, and it was labeled as hormone-sensitive.The Gleason score is assigned after a pathologist examines biopsy samples. Scores typically range from 6 to 10, with higher numbers indicating more aggressive cancer. A score of 9 falls into the most aggressive category. However, the score alone cannot tell us whether the cancer has spread outside the prostate.When prostate cancer spreads, the most common destination is the bones — particularly the spine, pelvis and ribs. It can also reach organs such as the lungs or liver. Once it has reached distant parts of the body, it is generally not curable, but treatment can put a brake on it for years.Prostate cancer can also be hormone-sensitive or hormone-resistant. Because it typically relies on testosterone to grow, lowering the hormone or blocking its effects can help control the cancer. Hormone-sensitive means it still responds to these treatments.Over time, most advanced or metastatic prostate cancers find ways to grow despite low testosterone levels, which mean they are now hormone-resistant. Lowering testosterone alone is no longer enough to control the cancer, so doctors have to turn to additional therapies.Knowing if the cancer has spreadThe most sensitive imaging test available today is a PSMA PET scan. It uses a radioactive tracer that seeks out a protein found on the surface of prostate cancer cells. Areas containing cancer may appear as bright spots, helping identify where the cancer has spread. The American Urological Association supports using this imaging test to determine whether high-risk prostate cancer has spread and to help establish its stage.A traditional bone scan, used for decades, highlights areas where bone is reacting to injury or disease. It remains an alternative imaging option, but PSMA PET is increasingly replacing its use.What areas light up and where matter when deciding on treatments. A single spot in the spine and cancer that has spread to the liver are both called stage 4, but they are not the same disease and may not be treated the same way.Doctors also consider how much cancer has spread. We label it as “low-volume” disease when the cancer has reached a limited number of areas. High volume is when the spread is more widespread or has reached other organs such as the liver or lungs.Both require treatment that works throughout the body. Treatment for metastatic disease generally includes therapy that works throughout the body. For men with low-volume disease, adding radiation to the prostate may also help them live longer.Biden has completed a course of radiation, but his team has not disclosed what area was treated or enough detail to determine whether his cancer would be considered low- or high-volume.Treatment has become more preciseBeyond starting more treatments earlier, doctors can increasingly tailor therapy to the biology of an individual man’s cancer. We can now test both the tumor and a patient’s own DNA for mutations that help guide treatment.Roughly 1 in 10 men with metastatic prostate cancer carries an inherited mutation affecting the body’s ability to repair DNA. The best known are BRCA1 and BRCA2, the same genes linked to some breast and ovarian cancers.Certain mutations found in the tumor or inherited DNA may make targeted drugs called PARP inhibitors an option. If a mutation is inherited, it also gives family members information they can act on through genetic counseling, testing and earlier screening.Another advance is radioligand therapy. If a scan shows that cancer cells carry a protein called PSMA, doctors can attach radiation to a molecule that seeks out that protein. Delivered through an IV, it targets cancer cells throughout the body. This approach was expanded last year to more men whose cancer had become hormone resistant.Living longer can come with costsEvery treatment can cause side effects. With hormone therapy, one of the first is often hot flashes, similar to what women experience during menopause. These are not dangerous, but they can affect a man’s quality of life.Fatigue is also common. Testosterone helps maintain muscle, so lowering it can reduce strength and energy. Regular walking and resistance training can help preserve muscle and reduce fatigue.The side effect almost no one talks about is loss of sex drive or low libido. At diagnosis, most men are thinking about staying alive, not their libido. But months later, it often matters. It is worth discussing with your care team and your partner rather than assuming it is simply the price of treatment.The side effect I worry about most is weaker bones. Low testosterone reduces bone density, while cancer deposits can weaken the bone’s structure. Follow-up care should include exercise, a bone-density scan, and ensuring adequate levels of calcium and vitamin D. For men with hormone-resistant cancer that has spread to bone, bone-protecting drugs can reduce the risk of fractures and other complications.New or worsening back pain, especially with leg weakness, numbness or trouble controlling the bladder or bowels? These could mean the cancer is pressing on the spinal cord. It is a true medical emergency that requires immediate attention.Cancer care requires a team approachIdeally, several doctors work together to coordinate a patient’s care. The urologist is often the starting point. A medical oncologist manages treatments that work throughout the body, while a radiation oncologist targets specific areas, whether that is the prostate itself or a painful bone lesion. The primary care doctor helps protect the patient’s heart and bones and looks after the person’s overall health.A man’s age, other medical conditions, ability to tolerate side effects and goals for treatment all shape treatment plans. Two men with nearly identical test results may be offered — or choose — different paths based on their health and priorities.Good communication among doctors is essential, but gaps can happen. Being your own advocate means knowing who is on your care team, asking questions and understanding your options.I also recommend bringing someone you trust to important visits for support and to take notes and help you remember what was discussed.More treatments, better testing offer hopeFor men worried about prostate cancer, talk with your health care provider about the benefits and risks of PSA testing. Black men and those with a strong family history should begin that conversation in their 40s. New urinary symptoms are often not cancer, but they still deserve attention, as does blood in the urine or semen, unexplained weight loss and/or persistent back or bone pain.For men living with advanced prostate cancer, there is reason for hope. There are more treatments and better testing than there were a decade ago, and good care pays attention to how a man feels, not just to what his scans show.The-CNN-Wire™ & © 2026 Cable News Network, Inc., a Warner Bros. Discovery Company. All rights reserved.
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