There are multiple reasons why health insurance premiums have become so unaffordable without significant subsidies to mask the cost: 

• The underlying cost of care itself is getting more expensive. Personnel shortages drive up the cost of doctors, nurses, and support staff.
• General inflation also plays a role.
• Today’s “superdrugs” can cost thousands of dollars per dose. 
• Hospitals continue to hide pricing and dodge price transparency rules.

Also, health insurance plans are required by law to include many kinds of coverage that most people don’t want or need. For example, traditional insurance plans must cover the cost of drug and alcohol treatment, mental health care, and are increasingly required to cover controversial procedures like sex change operations.

The more types of coverage that politicians force insurance companies to pay for, the higher they drive up premiums.

Additionally, health insurance companies must take on all applicants within the open enrollment or special enrollment periods, regardless of their medical history. This also drives up costs.