Commercial health plan satisfaction has fallen for the second year in a row, with members citing rising costs, unclear coverage, and inconsistent service as key frustrations.
JD Power’s 2026 U.S. Commercial Member Health Plan study scored overall satisfaction at 562 on a 1,000-point scale, down one point from 2025 and three points from 2024. The gap persists between insurer investments and what members actually value: affordability, claims resolution, access to care, and trust.
Only 30% of members now see their health plan as a trusted partner in their health and wellness.
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In regional rankings, Kaiser Foundation Health Plan topped California for the 19th straight year with a score of 640 and held the lead in Colorado for a second year at 560.
Meaghan Hafner, senior director of healthcare solutions at JD Power, said digital tools and customer experience upgrades haven’t moved the needle because they don’t tackle the core issues. “While health plans have made significant investments in digital tools and customer experience, those improvements aren’t translating into higher satisfaction because they do not address the parts of the experience that matter most to members, like understanding coverage, managing costs, accessing care and resolving claims,” she said.
When those fundamentals fail, even polished digital interfaces can’t offset the frustration.
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Cost remains the biggest pain point. Over half of members reported higher monthly premiums this year, while 34% saw annual deductible increases. Premium hikes correlated with a 116-point satisfaction drop, and deductible increases led to a 111-point decline.
Hafner said rebuilding trust starts with clarity. “Cost pressures are a defining part of the member experience right now, so rebuilding trust starts with making costs more predictable and easier to understand.” Plans that communicate costs transparently and minimize surprises tend to perform better, even when expenses rise.
Members respond more positively when the process feels consistent and supportive.
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Claims resolution also stood out as a major differentiator. Those rating the process as excellent gave an average satisfaction score of 734, compared with 614 for those calling it merely great.
Hafner noted that expectations are shifting. Members no longer judge health plans solely on coverage but on ease of use. “Expectations are increasingly shaped by simpler and more transparent experiences in other parts of their lives.”
For insurers, she added, the path forward isn’t adding more features but fixing the basics. “To keep up, health plans will need to focus less on adding features and more on making the experience simpler, more predictable, and easier to handle, especially when members are actively using their coverage.”
