Will Trump’s Announcement Expand Access to IVF? 

Published: Oct 27, 2025

Assistance with fertility care, a stated priority of President Trump, is an urgent need for many people. Rarely considered a “medically necessary” health service by health plans, only a minority of employers offer fertility benefits; and IVF is typically never covered by Medicaid or Medicare. The nationally representative KFF Women’s Health Survey finds that one in eight (13%) women ages 18 to 49 say they or their partner needed fertility assistance services at some point. While there are many obstacles to receiving fertility care, cost is by far the single largest barrier. Among those who reported needing fertility services at some point, 12% say they did not receive these services with cost cited as the leading reason.

During the 2024 campaign, Donald Trump pledged to make IVF free, and many have been waiting for the Administration to fulfill this promise. Following an executive order earlier this year, the October 16th White House announcement proposes to offer a discount on certain drugs that are used in IVF treatments through a new government website, TrumpRx.gov, and to develop additional options for employers to voluntarily offer assistance with fertility and family formation costs for their workers and their dependents. The impact of this plan, however, will be limited to either those covered by an employer that opts to cover these benefits or those who will be able to get discounts through the TrumpRx website once it is fully operational in 2026 and who can afford to pay the other costs associated with IVF that are not being made available at lower prices.

What are the features of Trump’s announcement on IVF?

The White House announcement focused on reducing the cost of some IVF drugs and clarifying options for employers to offer standalone fertility benefits for their employees and their dependents.  Here are some key takeaways about the Trump IVF plan:

IVF drug costs:  The Trump Administration says it will decrease the price of IVF drugs, Gonal-F, Ovidrel, and Cetrotide. People who use TrumpRx.gov will be connected to manufacturers who will sell them the drugs directly. This is based on a deal that the Administration made with the manufacturer, EMD Serono, to provide their medications to patients at Most Favored Nation (MFN) pricing, which would tie drug prices to the lowest price paid in a set of other developed nations. It is difficult to know precisely what the cost savings for IVF drugs specifically will be, both because of uncertainty around exactly what the MFN price level will be, and because the TrumpRx website is not yet operational. CMS estimates that women can save up to $2,200 per cycle of fertility drugs as a result of this deal on drugs that often cost over $5,000. While any reduction in the price of IVF drugs could be helpful, these are just a few of the many drugs that individuals may take throughout their IVF treatment. Gonal-F and Ovidrel are gonadotropins used to stimulate the ovaries and Cetrotide is a GnRH antagonist that prevents premature ovulation. Other medications involved in IVF cycles are oral contraceptive pills to control the timing of the menstrual cycle, as well as drugs that help prepare the uterine lining for implantation, stimulate egg growth, and prevent infections prior to embryo implantation. IVF treatment plans are very individualized to the person and not everyone going through IVF uses these specific discounted drugs. There are currently websites that already offer self-pay patients with discounts on fertility drugs, so the impact of the TrumpRx discount may depend on how it compares to existing discount programs. The White House announcement also states that the FDA will include a lower cost fertility drug in the initial round of recipients for the National Priority Review Voucher program, and that the review timeline will be expedited.

Fertility benefits: The administration states that they have created a new benefit option that makes it easier for employers to offer stand-alone fertility benefits–should they choose to. However, the pathway for these benefits was originally created in 1996 as part of the federal Health Insurance Portability and Accountability Act (HIPAA), which established the categories of “excepted benefits.” The Trump announcement does not create a new benefit category, rather it clarifies by explicitly stating that employers can offer fertility benefits under two subtypes of excepted benefits. Some employers have already been offering standalone fertility benefits without this level of regulatory specificity. In recent years, a number of companies, such as Carrot Fertility, Maven, and Progeny, have been established to offer such a product. Employers who offer comprehensive health insurance can use these programs to extend fertility benefits to their workers using a “group coverage” health reimbursement account (HRA) which allows employers to decide how much they want to spend on these benefits and does not have a federal spending cap. The White House plan clarifies that employers can use the following additional approaches to extend fertility benefits to their workers:

  • Independent, non-coordinated excepted benefit: Employers can currently offer standalone benefits for some specific services such as coverage for only a specified disease (such as cancer-only policies) and hospital indemnity insurance. The Trump announcement clarifies employers can voluntarily choose to also offer standalone insured fertility benefits, regardless of whether the employer also offers comprehensive health insurance. The Administration intends to do future rulemaking that would allow employers to offer standalone “self-insured” fertility benefits.  A freestanding fertility plan, however, would be of limited utility to people who are currently uninsured for fertility care unless it is offered along with comprehensive insurance that covers prenatal care and other costs associated with childbirth. The range and costs of services that such a plan might cover could be as comprehensive or narrow as the employer defines since it is an optional benefit. 
  • Limited excepted benefits: These plans include “excepted benefit health reimbursement accounts” (HRAs) that reimburse employees for their out-of-pocket fertility expenses, but employer contributions are capped at $2,150 for these accounts. This could be an option for employers who want to offer fertility benefits but want to limit their financial exposure to this relatively small amount, as it would only cover, on average, one -tenth of the cost of one IVF cycle. This might also include an Employee Assistance Program that provides coaching and navigator services related to fertility benefits. The Trump Administration is proposing future rulemaking to expand the ways employers can provide fertility benefits as limited excepted benefits, but do not outline these options in the announcement.  

What will be the impact of Trump’s IVF plan?

While many people are not insured for IVF, without a subsidy, mandate or some type of employer incentive, the President’s proposal is not likely to make a significant dent to the current gaps in access to IVF services,  as it essentially offers a discount for a limited set of drugs and clarifies that employers have pathways to offer a limited benefit without running afoul of ACA and HIPAA regulations. For people who lack coverage for IVF services, the discount on drugs through TrumpRx.gov could lower out of pocket costs for people who rely on those drugs as part of their treatment plan, but alone it does not address the majority of IVF costs, such as egg retrieval and embryo transfer.

The President’s announcement also encourages employers to offer IVF and other fertility benefits, but there is no mandate, nor are there any federal subsidies nor new tax incentives to encourage employers to offer these benefits to their workers. To implement a new mandate or tax incentive, Congressional action would be required. Employers already have the option to offer fertility benefits either as part of their insurance plan or as a standalone benefit. The KFF Employer Health Benefits Survey finds that one in four (27%) larger employers (200 or more workers) offers IVF coverage to their workers as do half (53%) of employers with at least 5000 workers. These benefits can vary greatly and may not cover the full cost of an IVF cycle, which on average ranges from $15,000 to $20,000, and many individuals struggling with infertility may need more than one IVF treatment cycle. 

Private insurance coverage for IVF has grown over the past decade, particularly as more states have enacted laws requiring plans in their state to cover services. These laws vary widely in scope and who is eligible for benefits. Some are limited to those who have a diagnosis of infertility, which effectively excludes single individuals and same sex couples. The White House announcement does not address any of these limitations. State laws, however, do not apply to self-funded plans, which cover about two-thirds (67%) of workers with employer-based insurance.

The plan also does not address gaps in fertility coverage faced by the nearly 16 million reproductive age women who are currently enrolled in Medicaid. Even with a discount through the TrumpRx website for some medications, the costs of the rest of IVF-related services would be prohibitive for most people on Medicaid who must have a low income to qualify for the program. A 2020 review of Medicaid programs conducted by KFF found that the vast majority of state programs did not cover fertility services, and among those who had limited coverage, no state provided comprehensive IVF services to Medicaid enrollees.

What are the chances for greater expansion of assistance with IVF costs and coverage?

IVF moved to the policy spotlight right after a 2024 ruling of the Alabama Supreme Court categorized embryos created through IVF as “unborn children”, bringing media attention to the potential implications of fetal personhood laws, which give rights to embryos. Fetal personhood is embedded in some state abortion bans and a variety of other public policies. The language is also widely promoted in conservative circles. For example, the Project 2025 blueprint refers to embryos as “aborted children” and opposes research using embryonic stem cells (which can be obtained through the IVF process). Many influential conservative groups, including the Southern Baptist Convention and Catholic Church, expressly oppose IVF.

This announcement comes at a time when the Trump Administration has laid off the staff of the Centers for Disease Control Division of Reproductive Health, including those who worked on the Assisted Reproductive Technology Surveillance team that ran the National Assisted Reproductive Technology (ART) Surveillance System, which collected data from assisted reproductive technology clinics in the U.S. and calculated and reported success rates for each clinic to monitor clinic outcomes. More recently, the majority of staff at the Office of Population Affairs under which the administration had proposed starting an Infertility Training Center was also let go. It is not clear what staff are left at HHS or CDC to track the provision of infertility treatment and to regulate the services.

To assist all people with coverage who want or need fertility care as the President promised during his campaign, Congress would need to approve a new law to either require or subsidize fertility and IVF coverage. In 2024, Congressional bills that would have established a national right to IVF failed as a result of opposition from nearly all Republican Senators. In May 2025, Representative Lauren Underwood introduced the Health Coverage for IVF Act of 2025, which would require small and non-group plans to offer comprehensive fertility coverage including IVF, but there has been no congressional movement on this bill to date.

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Medicare Advantage Enrollees Have Access to About Half of the Physicians Available to Traditional Medicare Beneficiaries

Authors: Matthew Rae, Jeannie Fuglesten Biniek, Tricia Neuman, and Karen Pollitz
Published: Oct 27, 2025

News Release: Medicare Advantage Provider Networks Limit Enrollees to About Half of the Physicians in Their Area That Are Available to Beneficiaries in Traditional Medicare, on Average

Enrollment in Medicare Advantage, the private plan alternative to traditional Medicare, has increased steadily over time. The growth in enrollment has been accompanied by an increase in the number of Medicare Advantage plans, with the average beneficiary having the option to choose among 42 plans in 2025, including 34 with prescription drug coverage. Most Medicare Advantage insurers use provider networks, along with other tools, such as prior authorization, to help manage utilization and lower costs. While these practices may contribute to insurers’ ability to offer extra benefits and reduce cost sharing, they may also impose barriers to care by restricting choice of physicians, hospitals, and other providers, introducing additional complexity in comparing and choosing plans, and creating potential for disruption in care arrangements for patients when their hospitals and physicians are no longer in-network.

Despite the wide range of Medicare coverage options available, there are limited decision-support tools for beneficiaries wishing to compare Medicare Advantage provider networks to each other and to traditional Medicare. While Medicare beneficiaries say that physician availability is an important factor in selecting their coverage, it can be challenging to assess which physicians are in-network across all available plans. In 2025, as with prior years, the Medicare Plan Finder did not include Medicare Advantage provider network information. Beneficiaries have been directed to each plan’s website to obtain information about the provider network, and typically, the network directories are not available in a uniform, easy-to-compare format. Further compounding the problem, these directories are often inaccurate. As of October 2025, in advance of the 2026 plan year, CMS will post provider directory information on the Plan Finder using information aggregated by a third party, and beginning in 2027, Medicare Advantage insurers will be required to submit provider information directly to CMS for publication online.  

To understand how much provider networks vary across Medicare Advantage plans, this brief examines the share of physicians available to Medicare Advantage enrollees as a share of physicians available to traditional Medicare beneficiaries, by county, plan characteristics, and physician specialties, using 2022 Medicare Advantage provider directories. (See Methods.) The analysis finds wide variation in network breadth across plans and compared to traditional Medicare The size of a Medicare Advantage plan’s network does not necessarily indicate whether it includes enough physicians with the right expertise who are available when patients need care, or whether those physicians are accepting new patients, though smaller networks increase the chances that enrollees pay more for going out of network or experience some disruption in their care arrangements.

Key Findings:

  • Medicare Advantage enrollees were in a plan that included just under half (48%) of all physicians available to traditional Medicare beneficiaries in their area in 2022, on average. Narrower networks limit which doctors, specialists, and other health care providers are available to Medicare Advantage enrollees, unless they are willing and able to pay more to go out-of-network. Narrower networks can also be disruptive for patients who need to switch doctors or hospitals to stay within the network for their care.
    • For the one-fifth of Medicare Advantage enrollees in plans with the narrowest network, two out of three physicians available to beneficiaries in traditional Medicare in their area were out-of-network.
    • Conversely, for the one-fifth of Medicare Advantage enrollees in plans with the broadest networks, fewer than one-third of physicians available to traditional Medicare beneficiaries were out of their plan’s network.
  • The breadth of Medicare Advantage networks varied widely across counties. Among the 30 counties with the largest Medicare Advantage enrollment, the share of physicians available to Medicare Advantage enrollees as a share of physicians available to traditional Medicare beneficiaries ranged from an average of 18% in San Diego, CA to an average of 58% in Pima, AZ (Tucson). This variation across geographic areas means that some Medicare Advantage enrollees have more choice among health care providers than others.
  • In counties where larger shares of the population were people of color, a smaller share of physicians available to traditional Medicare beneficiaries were in-network, on average, than in other counties (37% vs 52%).
  • Even within the same county, physician networks often varied widely across plans. One third (32%) of all Medicare beneficiaries lived in a county where at least one plan had less than one-quarter of physicians available to traditional Medicare beneficiaries and at least one plan included at least two-thirds of physicians available to traditional Medicare beneficiaries, though these variations are difficult for beneficiaries to decipher and not obvious when potential enrollees are comparing their Medicare coverage options.
  • The share of physicians available to Medicare Advantage enrollees varied by specialty. Generally, larger shares of outpatient medical and surgical specialists were in plan networks than primary care physicians, with as many as 72% of ophthalmologists available to traditional Medicare beneficiaries in plan networks compared to only 55% of primary care physicians, on average.
  • Medicare Advantage plan quality star ratings were not correlated with the breadth of the physician network. Though star ratings were intended to help beneficiaries choose a plan that best meets their needs, they do not convey the information needed for potential enrollees who prioritize the breadth of the provider network. 

Medicare Advantage Enrollees had Access to About Half of the Physicians Available to Traditional Medicare Beneficiaries.

Traditional Medicare beneficiaries may see any physician who participates in Medicare, as long as the physician is taking new patients. According to a separate KFF analysis, just 1% of non-pediatric physicians have formally opted out of the Medicare program nationwide, and the vast majority of office-based physicians accept new Medicare patients. In contrast, enrollees in Medicare Advantage must see providers who participate in their plan’s network or potentially pay higher cost-sharing. On average, Medicare Advantage enrollees were in a plan that included about half (48%) of physicians available to traditional Medicare beneficiaries in their area in 2022 (Figure 1).

Some physicians are substantially less likely to participate in a Medicare Advantage network, such as hospital-based emergency medicine doctors and anesthesiologists. When these providers deliver certain services, such as care in an emergency room or anesthesia during surgery at an in-network facility, patients will not be liable for additional costs because the doctor is out-of-network. If hospital-based physicians are excluded from the analysis, the share of physicians available to traditional Medicare beneficiaries who participate in Medicare Advantage networks increases to 62%, on average. This analysis considers all individual-level physicians who billed traditional Medicare, including hospital-based physicians.  Based on available data is not possible to identify which physicians, under what circumstances, would not lead to higher costs for patients if the physician were out-of-network.

Many Medicare Advantage enrollees were in plans with narrower networks that included substantially fewer physicians. One in five Medicare Advantage enrollees were in plans with 32% or fewer of the physicians serving traditional Medicare beneficiaries. This means that for these Medicare Advantage enrollees, more than two out of three physicians available to traditional Medicare beneficiaries were out-of-network. At the same time, many Medicare Advantage enrollees were in plans with broader networks, with one in five Medicare Advantage enrollees in plans that included at least 63% of the physicians available to traditional Medicare (Figure 1).

The Average Medicare Advantage Enrollee is in a Plan That Includes Less Than Half of the Physicians Available to Traditional Medicare Beneficiaries

The share of physicians included in Medicare Advantage plan networks varied widely across counties.

Medicare Advantage plans are offered at the county level. Like other characteristics of the Medicare Advantage market, such as plan availability, the average breadth of Medicare Advantage plan networks varied widely across counties, ranging from an average of just 15% of physicians available to traditional Medicare beneficiaries in Charles County, MD (outside Washington, D.C.) to 88% of physicians available to traditional Medicare beneficiaries in Redwood, MN (in southern Minnesota).

Among the 30 counties with the largest Medicare Advantage enrollment, the share of physicians included in plan networks ranged from an average of 18% in San Diego, CA, to an average of 58% in Pima, AZ (Tucson).

Just 30 counties are home to more than 20% of all Medicare Advantage enrollees. In these counties, the share of physicians available to traditional Medicare beneficiaries included in plan networks ranged from an average of 18% in San Diego, CA to 58% in Pima, AZ (Tucson). At least half of physicians were in-network in just 10 of these 30 counties. Conversely, in 20 of these 30 counties, fewer than half of all physicians available to traditional Medicare beneficiaries were in-network for Medicare Advantage enrollees, on average (Figure 2).

On Average, Medicare Advantage Enrollees in Nearly All Large Counties Were in Plans That Included Fewer Than Half of Local Physicians

Counties with relatively larger populations of people of color had smaller Medicare Advantage networks, on average

Medicare Advantage enrolls Black, Hispanic, and Asian and Pacific Islander Medicare beneficiaries at higher rates than White Medicare beneficiaries. Across dozens of measures examined in the literature, people of color, particularly Black Medicare Advantage enrollees, often fare worse than White Medicare Advantage enrollees.

Plans in counties with a disproportionate share of residents who are people of color tended to have narrower networks. More specifically, Medicare Advantage enrollees living in counties with the largest share of people of color had access to just 37% of the physicians available to traditional Medicare beneficiaries, on average, compared with 52% in counties where people of color made up a smaller share of the population (Figure 3).

The differential access to physicians persists when looking only within metropolitan counties (36% vs. 51%), which have narrower networks on average (see below) and often larger populations of people of color.

Counties With Relatively More People of Color had Narrower Physician Networks, on Average

Counties with a larger number of insurers had smaller physician networks, on average.

In 2022, the average Medicare beneficiary could choose from plans offered by nine firms, and one-quarter of beneficiaries had access to plans from 11 or more firms. On average, Medicare Advantage enrollees in counties where more firms offered plans were in plans with smaller networks. Specifically, Medicare Advantage enrollees in counties with 11 or more firms were in plans that included less than 4 in 10 (39%) physicians available to traditional Medicare beneficiaries in the area, compared to 54% among Medicare Advantage enrollees in counties with five or fewer firms (Figure 4). The share of physicians who were in-network on average was similar when examining all Medicare Advantage enrollees and just those in large counties.

A Smaller Share of Physicians Were In-Network in Counties with More Issuers  Offering Medicare Advantage Plans

In rural counties, more than half (53%) of physicians available to traditional Medicare beneficiaries were in-network, on average, slightly more than the national average.

A larger share of Medicare beneficiaries living in rural areas get their Medicare coverage through traditional Medicare rather than Medicare Advantage, though enrollment in Medicare Advantage has grown substantially in rural areas in recent years. On average, Medicare Advantage enrollees in rural areas have a slightly larger share of physicians available to traditional Medicare beneficiaries in the network than those in metropolitan areas, 53% compared with 47%. A substantially smaller share of physicians practice in rural areas than in metropolitan areas, so broader networks in rural areas may not translate into better access to physicians.

The size of physician networks varied widely within most counties.

Most Medicare beneficiaries can choose from dozens of Medicare Advantage plans offered in their county. The plans vary across many dimensions, such as premiums, cost sharing, out-of-pocket limits, prescription drug coverage, use of prior authorization, and the availability and generosity of benefits for non-Medicare covered services. Additionally, the breadth of physician networks varies widely.

Nearly two-thirds of Medicare Advantage enrollees lived in a county with at least one plan that had fewer than 25% of physicians available to traditional Medicare beneficiaries in-network and, conversely, at least one plan with nearly two-thirds (64%) of the physicians available to traditional Medicare beneficiaries in-network. Such a large variation in the breadth of physician networks means that plan choice has substantial implications for which doctors someone can see without incurring additional cost-sharing.

Figure 5 shows the share of physicians available to traditional Medicare beneficiaries who are in network for plans offered in the 30 counties with the largest Medicare Advantage enrollment (which represents 23% of all Medicare Advantage enrollment). For example, in Hennepin County, MN (which includes Minneapolis), the share of physicians available to traditional Medicare beneficiaries who were in network ranged from 14% to 88%. In Clark County, NV (which includes Las Vegas) the difference across plans was smaller, but still substantial, ranging from 12% to 43%. 

Wide Variation in Physician Networks Across Large Counties, but Few Cover More Than Three-Quarters of Physicians

Some doctors did not participate in any Medicare Advantage plan network. On average, approximately 1 in 7 (14%) physicians who submitted Medicare claims were not included in any Medicare Advantage plan network. A large share of the doctors who do not participate in any Medicare Advantage network are hospital-based physicians, such as emergency medicine doctors and anesthesiologists (21% and 19% of all physicians who are not in any Medicare Advantage network, respectively). While obtaining care from a non-network provider generally results in higher costs for patients, that is not always the case. Specifically, emergency care is covered regardless of the provider’s network status. Additionally, patients are protected against out-of-network charges for certain services provided during a hospital stay or procedure that occurs in a hospital setting, when specific conditions are met, such as when the facility or primary provider (e.g., a surgeon) is in network. Otherwise, beneficiaries who see other types of physicians who are not in any Medicare Advantage plan network would either pay more to maintain continuity of care or need to find a new doctor.

There were differences in the size of Medicare Advantage networks across some Medicare Advantage plan characteristics, but not others.

Medicare Advantage plans with high-quality star ratings did not have larger physician networks.

One of the pieces of information that Medicare beneficiaries have when selecting a plan is the quality star rating. Medicare Advantage plans are rated on a scale of 1-to-5 stars, which reflect performance on a large set of indicators, including customer service, consumer satisfaction, the share of enrollees who receive vaccines and screenings, and management of certain conditions, among others. Both plan availability and enrollment are skewed towards plans with higher stars, with more than 80% of enrollees in this analysis in a plan with at least 4 stars in 2022.

On average, enrollees in plans with 4.5 or 5 stars had a network that included 49% and 43% of physicians available to traditional Medicare beneficiaries, respectively, compared to 51% for plans with 4 stars and 50% for plans with 3.5 stars (Figure 6). While star ratings do not incorporate any measures of network breadth, they are one of the more salient measures available to potential enrollees.

Plan Star Ratings Were Not Related to the Breadth of Their Physician Networks

PPOs had broader physician networks, on average, than HMOs.

In recent years, preferred provider organization (PPO) plans have comprised a growing share of the available Medicare Advantage plans. For example, between 2017 and 2025, the share of plans that were local PPOs increased from 24% to 43%. In 2025, more than half of Medicare Advantage enrollees were in HMOs. While PPOs and health maintenance organizations (HMOs) both use provider networks, PPOs have some out-of-network coverage, while typically HMOs do not, except in the case of emergencies. In 2022, just over half (54%) of physicians available to traditional Medicare beneficiaries were in-network in PPO plans, on average, compared with 45% in HMO plans. However, the size of the networks varied, particularly for HMOs, and many included more physicians than the average PPO plan (Figure 7).

On Average PPO Plans are Broader, but Many HMO Plans Have Wider Networks Than PPO Plans

On average, Medicare Advantage plans offered by BlueCross Blue Shield affiliates, UnitedHealthcare, and Centene included at least half of the physicians available to traditional Medicare beneficiaries.

The average share of in-network physicians varied across Medicare Advantage insurers. Enrollees covered by UnitedHealthcare and Blue Cross Blue Shield affiliated organizations included 58% and 59% of the physicians available to beneficiaries in traditional Medicare, respectively. Conversely, enrollees in Humana and CVS covered less than half (44% and 46% respectively), on average (Figure 8).

Network Breadth Across Insurers

At the same time, there is considerable variation across plans offered by the same insurer. For example, among enrollees in Humana Medicare Advantage plans, 6% percent had 25% or fewer physicians available to traditional Medicare beneficiaries in-network, and 34% had at least half of physicians available to traditional Medicare beneficiaries in-network (data not shown).

In many cases, a single insurer may offer multiple networks in the same area. For example, in Maricopa, AZ (Phoenix), UnitedHealthcare offered 12 plans with 12 different networks, ranging from 37% to 61% of physicians available to traditional Medicare beneficiaries. In Broward, FL (Fort Lauderdale) Humana offered 19 plans with three networks, ranging from 26% to 44% of physicians (data not shown).

The share of physicians included in Medicare Advantage networks ranged across specialties

CMS has network adequacy rules that require Medicare Advantage plans to contract with a certain number of primary care physicians, as well as physicians with specific specialties. Many of the specialties that are included in the network adequacy regulation participate at a higher rate on average than physicians without specific requirements.  Nearly three-in-ten physicians who submitted a Part B claim for a traditional Medicare beneficiary were hospital-based physicians. These physicians were less likely to be included in Medicare Advantage directories  (21%). Hospital-based physicians may have less incentive to participate in Medicare Advantage networks because the services they most frequently provide are likely to be covered regardless of network status. For example, emergency medicine doctors were among the most common types of doctors to not participate in a Medicare Advantage network. When a person receives emergency services, coverage of those services is not subject to network restrictions, so it would not matter that the physician providing the service is not in network.

Generally, Medicare Advantage plans included a larger share of outpatient medical and surgical specialists subject to network adequacy rules than primary care providers, with access ranging from 61% for neurology to 72% for ophthalmology on average (Figure 9).  The specific specialties and distance requirements established by these rules are listed in the Appendix. These physician categories do not represent all physicians or specialists an enrollee may need, but highlight some of the key capabilities that older Americans often require.

Medicare Advantage Enrollees Had Access to  Wide Share of Select Outpatient Specialists

An ongoing challenge in assessing network breadth is the lack of up-to-date, reliable data. As detailed in the Methods, this analysis has several limitations: it includes only individual physicians listed in plan directories who submitted at least one Part B claim during the year. “Phantom” providers those in the directory but not actually accepting the plan in the place and specialty listed, can overstate network size, while participating providers missing from directories can make networks appear narrower than they are.

This work was supported in part by Arnold Ventures. KFF maintains full editorial control over all of its policy analysis, polling, and journalism activities.
 
Karen Pollitz, a retired Senior Fellow at KFF contributed to this analysis.

Methods

This analysis mirrored the methods used in How Narrow or Broad Are ACA Marketplace Physician Networks? A longer description of trimming, assigning providers to addresses and specialties, as well as other data sources, is available here.

In total, 4,200 individual HMO/PPO MA plans from 2022 are included, covering a total of 20.3 million Medicare Advantage enrollees. This analysis excludes enrollees in employer- or union-sponsored group plans as well as Medical Savings Account (MSA) and Private Fee-For-Service plans (PFFS). 11% of enrollees were dropped from the analysis either because data were not available or based on the trimming rules described in the linked methods.

An issuer may use the same provider network for several plans, either in different markets or within the same service area. In some areas, insurers may use multiple networks across the plans they offer. Plans vary in important respects other than the provider network, including which services are covered and the structure of cost-sharing. In total, Medicare Advantage plans used 981 networks in 2022.

This brief considers the share of available physicians around an enrollee’s home who are listed in their plan’s network directory. Information on plan provider directories was collected by Ideon and made publicly available with support from the Robert Wood Johnson Foundation. Available physicians are those who practice within the county or are within the distance standards specified in the Medicare Advantage network adequacy standards. Thus, a wider radius is used for enrollees living in more rural counties or for specialist physicians. For example, in a large metro county, PCPs are included if they are within the county or within 5 miles of its population-weighted center, compared to 30 miles from the county center in rural areas. A specialist, such as a cardiologist, is included in large metro counties if they are within the county or 10 miles of its center and within 60 miles of a rural county.

Private health plan network directories often include significant numbers of “phantom” physicians who are not actually in-network, sometimes because they have retired or are otherwise no longer providing care. To estimate the total number of physicians who are in active practice, we relied on MD-PPAS, a federal database of physicians who submitted at least one Medicare Part-B claim in 2022. This data set is based on claims and therefore identifies individual-level physicians who saw at least one Medicare patient in the year. Medicare Part B is the largest payer of physician services and disabled Americans. Virtually all non-pediatric physicians participate in the program, with about 1% formally opting out together. MedPac, reports that the share of clinicians who accept Medicare is comparable to the share that accept private insurance. In total, 680,000 physicians, including 181,000 PCPs were included in MD-PPAS in 2022. MD-PPAS categorizes physicians into five different specialists based on the services they submitted claims for; these are primary-care (26% of physicians), medical specialists (19%), surgical specialists (16%), OBGYN (5%), hospital-based specialists (29%), and psychiatrists (4%).  

This brief calculates a physician participation rate, or the share of MD-PPAS physicians who were listed in each MA directory. While this method ensures that physicians who are not working at all, are not included in the analysis, networks may still include “phantom” providers who are actively practicing but who are inaccurately listed as participating in the plan. Further, this analysis does not consider whether the physician is currently seeing patients or for which services they are in-network.  Conversely, only physicians enumerated in the directory are included.  As explained in the linked methods, physicians associated with group practices, physicians working outside of their primary addresses, and others may be excluded.

Information on plan type, star ratings, plan enrollmen,t and plan characteristics was collected from CMS in a method described here and here. Information of the demographic characteristics of enrollees was collected from the Master Beneficiary Summary File (MBSF), 2022. Information on county characteristics was obtained from the 2020 CDC/ATSDR Social Vulnerability Index. Data on physician supply in counties was obtained from the Area Resource File (ARF) 2022.

Appendix

Medicare Advantage plans are generally required to include a minimum number of providers across various specialties and facility categories. Within Medicare Advantage network adequacy standards, plans may still include a tiny fraction of the providers working in or near the county. These regulations act as a floor and grant plans considerable latitude. This brief considers the share of available physicians around an enrollee’s home who are listed in their plan’s network directory. Available physicians are those who practice within the county or are within the distance standards specified in the Medicare Advantage network adequacy standards (Table 1).

Mileage Thresholds for Defining Local Areas

In total, CMS designates 78 “Large Metro” counties based on their population and population density, and 720 “Metro” counties. For example, Large Metro areas are classified as counties with at least a million people and a population density of at least 1,000 people per square mile, or counties with between 500,000 to 999,999 people and a population density of at least 1,500 people per square mile, or counties with a population density of at least 5,000 people. The county classifications follow the definitions used in the Medicare Advantage network adequacy rules (Table 3-1). Most Medicare Advantage enrollees live in one of these urban county-designations, including 29% in “Large Metro” counties and 53% in “Metro” counties.

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News Release

Medicare Advantage Provider Networks Limit Enrollees to About Half of the Physicians in Their Area That Are Available to Beneficiaries in Traditional Medicare, on Average

Published: Oct 27, 2025

With Medicare’s annual open enrollment period underway, a new KFF analysis finds that Medicare Advantage enrollees, on average, had access to just under half (48%) of the physicians in their area who were available to people enrolled in traditional Medicare.

The finding illustrates a key tradeoff for beneficiaries in choosing Medicare Advantage.  Such plans can be appealing to beneficiaries because they offer extra benefits and cap out-of-pocket costs without the need for supplemental coverage. But the plans’ provider networks, which help insurers manage utilization and costs, also restrict enrollees’ choice of physicians, hospitals, and other providers without paying additional cost. Changes in provider networks can be disruptive for patients when their hospitals and physicians are no longer in-network.

In the analysis, KFF researchers document how much networks vary across plans by using 2022 Medicare Advantage provider directories to assess the share of physicians available to plans’ enrollees as a share of all physicians that submit claims for providing care to traditional Medicare beneficiaries, by county, plan characteristics, and physician specialties.

Among the key findings:

  • The one-fifth of Medicare Advantage enrollees in plans with the narrowest networks had in-network access to just about one-third of all physicians that were available to people in traditional Medicare. Conversely, the one-fifth of Medicare Advantage enrollees in plans with the broadest networks had in-network access to more than two-thirds of physicians available to beneficiaries in traditional Medicare.
  • The size of Medicare Advantage provider networks varies widely both across and within counties, which can make it hard for beneficiaries to decipher which option is best for them when choosing a plan.
  • The share of physicians available to Medicare Advantage enrollees varied by specialty. Generally, larger shares of outpatient medical and surgical specialists were in Medicare Advantage plan networks than primary care physicians.

Prior KFF research shows that beneficiaries value being able to choose their own doctors, but the vast majority of the nation’s nearly 69 million Medicare beneficiaries do not compare coverage options or switch plans.

This year the Centers for Medicare & Medicaid Services has a new tool on the online Medicare Plan Finder that allows beneficiaries to enter up to five of their preferred providers to more easily determine if they are in a plan’s network. Users can sort plans in their area by whether a “must-have provider” is in network. The Medicare open enrollment period began Oct. 15 and runs through Dec. 7.

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U.S. Foreign Aid Freeze & Dissolution of USAID: Timeline of Events

Published: Oct 24, 2025

Starting on his first day of his second term in office, President Trump and his administration have taken several executive actions that directly impact U.S. global health efforts. This timeline, which is a companion resource to components of KFF’s Overview of President Trump’s Executive Actions on Global Health, provides a detailed overview of actions, including counter-actions, related to the administration’s efforts to freeze all U.S. foreign aid, dissolve the U.S. Agency for International Development (USAID), which implements most U.S. global health programs, and reorganize the Department of State. It will be updated as needed to reflect additional developments. 

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Overview of President Trump’s Executive Actions on Global Health

Published: Oct 24, 2025

Note: Originally published on Jan. 28, 2025, this resource is updated as needed, most recently on October 24, 2025, to reflect additional developments. 

Starting on the first day of his second term, President Trump began to issue numerous executive actions, several of which directly address or affect U.S. global health efforts.* This guide provides an overview of these actions, in the order in which they were issued. The “date issued” is date the action was first taken; subsequent actions are listed under “What Happens/Implications.” See an accompanying timeline of events specific to the foreign aid review and USAID dissolution.

President Trump’s Executive Actions on Global Health

Initial Rescissions Of Harmful Executive Orders And Actions, January 20, 2025
PURPOSE: Initial rescissions of Executive Orders and Actions issued by President Biden.

Among these orders are several that addressed the COVID-19 pandemic and global health security, such as Executive Order 13987 (Organizing and Mobilizing the United States Government To Provide a Unified and Effective Response To Combat COVID-19 and To Provide United States Leadership on Global Health and Security),  which among other things established the National Security Council Directorate on Global Health Security and Biodefense and a Senior Director position to oversee it.

What Happens Next/Implications: Given that most of the provisions in the COVID-19 and Global Health Security actions issued by President Biden are no longer current or relevant, the rescissions of these actions are likely to have minimal effect on government policies. One exception may be the elimination of the Directorate of Global Health Security and Biodefense and its Senior Director at the National Security Council, which were responsible for interagency coordination on global health security matters during the Biden Administration. The elimination of this office echoes a similar move made during the first Trump Administration to eliminate an NSC Directorate for Global Health Security, and raises questions about who and which offices at NSC (and across the government) will fill this coordination role in the new Administration. More rescissions of other Biden administration Executive Actions may be issued at a later date.
Withdrawing The United States From The World Health Organization, January 20, 2025
PURPOSE: To withdraw from the World Health Organization (WHO).

“The United States noticed its withdrawal from the World Health Organization (WHO) in 2020 due to the organization’s mishandling of the COVID-19 pandemic that arose out of Wuhan, China, and other global health crises, its failure to adopt urgently needed reforms, and its inability to demonstrate independence from the inappropriate political influence of WHO member states.  In addition, the WHO continues to demand unfairly onerous payments from the United States, far out of proportion with other countries’ assessed payments.  China, with a population of 1.4 billion, has 300 percent of the population of the United States, yet contributes nearly 90 percent less to the WHO.”

ACTIONS: The United States intends to withdraw from the WHO. 
• The Presidential Letter to the Secretary-General of the United Nations signed on January 20, 2021, that retracted the United States’ July 6, 2020, notification of withdrawal is revoked.
• Executive Order 13987 (Organizing and Mobilizing the United States Government to Provide a Unified and Effective Response to Combat COVID–19 and To Provide United States Leadership on Global Health and Security), which, among other things, called for “engaging with and strengthening the World Health Organization” is revoked.
• Assistant to the President for National Security Affairs shall establish directorates and coordinating mechanisms within the National Security Council apparatus as necessary and appropriate to safeguard public health and fortify biosecurity.
• The Secretary of State and Director of the Office of Management and Budget shall take actions to pause future transfer of any U.S. funds, support, or resources to WHO; recall and reassign U.S. government personnel or contractors working in any capacity with WHO; and identify credible and transparent U.S. and international partners to assume necessary activities previously undertaken by WHO.
• The Director of the White House Office of Pandemic Preparedness and Response Policy shall review, rescind, and replace the 2024 U.S. Global Health Security Strategy.
• The Secretary of State shall immediately inform the Secretary-General of the United Nations, any other applicable depositary, and the leadership of the WHO of the withdrawal.
• While the withdrawal is in progress, Secretary of State will cease negotiations on the WHO Pandemic Agreement and the amendments to the International Health Regulations, and states that “actions taken to effectuate such agreement and amendments will have no binding force on the United States.”		What Happens Next/Implications: President Trump initiated a process to withdraw from the WHO during his first term in office, a process that takes a year to finalize, and halted funding. This time period was not met when President Biden took office and he reversed this decision and restored funding. Now, after issuance of a formal letter of withdrawal United Nations and WHO, the process will be initiated once again. Such a letter has been issued, indicating that membership will end as of January 22, 2026.

Per the Executive Order, U.S. government representatives may not work with WHO. While U.S. representatives attended the Executive Board meeting in February (the U.S. previously held a seat on the Executive Board), no representatives attended the World Health Assembly in May, where world leaders adopted the Pandemic Agreement. On May 30, the White House released details on the President’s Budget Request for FY 2026, requesting eliminated funding for WHO. Further, on June 3, the administration asked Congress to rescind funds previously appropriated for fiscal years 2024 and 2025, including contributions to WHO. However, for both the FY 2026 appropriations and FY2024-25 rescissions, Congress will determine the final funding levels.

As the largest donor to WHO providing approximately 16%-18% of the organization’s revenue, the absence of U.S. funding will have an impact WHO’s operations, as will the loss of U.S. technical expertise. See: KFF Fact Sheet and Quick Take
Reevaluating And Realigning United States Foreign Aid, January 20, 2025
PURPOSE: To pause funding and review all U.S. foreign assistance to assess alignment with American values.

The U.S. “foreign aid industry and bureaucracy are not aligned with American interests and in many cases antithetical to American values. They serve to destabilize world peace by promoting ideas in foreign countries that are directly inverse to harmonious and stable relations internal to and among countries.”

“It is the policy of United States that no further United States foreign assistance shall be disbursed in a manner that is not fully aligned with the foreign policy of the President of the United States.”

Calls for:

• 90-day pause in U.S. foreign development assistance (new obligations or disbursements) to assess programmatic efficiencies and consistency with U.S. foreign policy.
• Review of U.S. foreign assistance programs by the responsible department and agency heads under guidelines provided by the Secretary of State, in consultation with the Director of OMB.
• Responsible department and agency heads, in consultation with the Director of OMB, will make determinations within 90 days of this order on whether to continue, modify, or cease each foreign assistance program based upon the review recommendations, with the concurrence of the Secretary of State.
• New obligations and disbursements may resume for a program prior to the end of the 90-day period if a review is conducted, and the Secretary of State or his designee, in consultation with the Director of OMB, decide to continue the program in the same or modified form.  Additionally, any other new foreign assistance programs and obligations must be approved by the Secretary of State or his designee, in consultation with the Director of OMB.
• The Secretary of State may waive the pause for specific programs.		What Happens Next/Implications: Almost all global health programs are funded through foreign aid appropriations and are therefore subject to this order. The order temporarily freezes any new U.S. government spending (obligations or disbursements) through these programs, which could interrupt implementation of programs for which funds have not yet been obligated. It also calls for a 90-day review of all foreign aid programs. Key developments are as follows:
• On January 24, 2025, A Notice on Implementation of the Executive Order was issued by USAID which, among other things, calls for stop-work orders to be issued for all existing foreign assistance awards (not just new obligations and disbursements). It notes that waivers have been granted for: foreign military financing for Israel and Egypt and emergency food assistance (and related expenses) and, on a temporary basis, salaries and related administrative expenses, including travel, for U.S. direct hire employees, personal services contractors, and locally employed staff. The stop-work order on existing awards halted U.S. global health (and other foreign assistance) programs that were already underway, placing key programs at risk of not being able to provide critical services, and affecting access for individuals on the ground, unless a waiver was received.
• On January 28, the Secretary of State  issued a blanket waiver for life-saving humanitarian assistance programs, which also lays out a process for requesting additional waivers (more information is here). This guidance also states that the waiver does not apply to “activities that involve abortions, family planning, conferences, administrative costs [unless associated with waived activities], gender or DEI ideology programs, transgender surgeries, or other non-life saving assistance.”
• On February 1, PEPFAR, the global HIV/AIDS program, was granted a limited waiver enabling it to resume or continue “urgent life-saving HIV treatment  services”, defined as a set of care and treatment services and prevention of mother-to-child transmission services.
• On February 4, some additional services for other global health programs  – tuberculosis; malaria; acute risks of maternal and child mortality, including severe acute malnutrition; and other life-threatening diseases and health conditions – deemed to be “lifesaving” were also granted a limited waiver to allow them to resume or continue.
• On February 6, a lawsuit was filed by Democracy Forward and Public Citizen Litigation Group, on behalf of the American Foreign Service Association and American Federation of Government Employees, challenging the foreign aid funding freeze, the plan to put most staff on leave, and the fact that staff had already been placed on leave; on February 7, they filed a temporary restraining order (TRO). That same day, a temporary restraining order was issued by the U.S. District Court in the District of Columbia preventing the government from placing additional staff on leave or evacuating staff back to the U.S., and requiring reinstatement of all staff already placed on leave, until February 14. The court did not grant a TRO on the funding freeze, on the grounds that the plaintiffs in this case did not demonstrate that the freeze caused them irreparable harm. On February 13, the court extended the TRO through February 21 (further actions are described below, as this case was combined with another for purposes of the court’s consideration).
• On February 10, a lawsuit was filed in the U.S. District Court for the District of Columbia on behalf of two U.S. organizations seeking emergency relief from the freeze on funding for foreign assistance (AVAC v. United States Department of State).
• On February 11, a lawsuit was filed in the U.S. District Court for the District of Columbia on behalf of several U.S. organizations challenging the executive order and subsequent actions freezing foreign aid and dissolving USAID, and asking the court to temporarily restrain and preliminarily and permanently enjoin Defendants from implementing these actions (Global Health Council v. Trump).
• On February 13, the court, in a ruling pertaining to the February 10 and February 11 lawsuits brought by numerous U.S. organizations, issued a TRO preventing the Trump administration from “suspending, pausing, or otherwise preventing the obligation or disbursement of appropriated foreign-assistance funds in connection with any contracts, grants, cooperative agreements, loans, or other federal foreign assistance award that was in existence as of January 19, 2025; or issuing, implementing, enforcing”, or “otherwise giving effect to terminations, suspensions, or stop-work orders in connection with any contracts, grants, cooperative agreements, loans, or other federal foreign assistance award that was in existence as of January 19, 2025.”
• On February 14, the parties filed a joint status report proposing an expedited preliminary injunction briefing schedule.
• On February 18, the government filed a required status report stating that, despite the TRO, it had the authority to cancel contracts and suspend grant awards.
• This was followed by a February 19 request by the February 10 plaintiffs (AVAC v. Department of State) for an emergency motion to enforce the TRO and to hold the defendants in civil contempt.
• The defendants filed a required response on February 20, stating that they have not violated the TRO and should not be held in contempt, which was again opposed by the plaintiffs. Also on February 20, the February 11 plaintiffs (Global Health Council v. Trump) filed a response to the defendant’s status report with a motion to enforce the TRO.  The court reaffirmed the TRO on February 20 (but did not hold the defendants in contempt), stating it was prepared to hold a hearing on the preliminary injunction motions in both cases by March 4, 2025 and that the TRO would be in place through March 10, 2025, or the date the Court resolves the preliminary injunction motions, whichever is sooner.
• The plaintiffs filed an emergency order to enforce the TRO on February 24, due to continued lack of payment, and the court issued a motion to enforce on February 25. The government appealed, (asking for a stay pending appeal) but this was denied by the court. The government then appealed to the Supreme Court and was granted a stay until February 28 while the case was considered.
• On March 5, the Supreme Court denied the government’s request to vacate the federal district court’s TRO, sending the order back to the district court to clarify the government’s obligations for ensuring compliance with the TRO.
• On March 6, the federal district court judge ordered the government to release all payments that were due to plaintiffs as of February 13, by Monday, March 10 at 6pm, and on March 10, the federal district court judge preliminarily enjoined the government from taking certain actions related to the foreign aid freeze.
• On March 10, Secretary Rubio announced that a six-week review had been completed and that 83% of programs at USAID (5,200 contracts) had been cancelled. That same day, the court  preliminarily enjoined the government from enforcing actions taken to implement the foreign aid freeze (requiring it to reverse any terminations, suspensions, and stop-work orders and to pay for any work completed by February 13). The court stated that the government was “enjoined from unlawfully impounding congressionally appropriated foreign aid funds and shall make available for obligation the full amount of funds that Congress appropriated for foreign assistance programs in the Further Consolidated Appropriations Act of 2024.”
• On April 1, the government filed an appeal with the U.S. Court of Appeals for the District of Columbia challenging the preliminary injunction issued on March 10.
• On April 17, the administration extended the foreign aid review for another 30 days from the original deadline of April 20, 2025.
•On May 2 and May 30, the White House released information on its budget request for FY 2026, proposing significant decreases, and in some cases eliminations, of funding for global health activities. However, Congress will determine the final funding levels.
• On June 3, the administration asked Congress to rescind previously appropriated funds for fiscal years 2024 and 2025, including $8.3 billion in foreign assistance, of which at least $1.2 billion was designated for global health. However, Congress will need to approve any potential rescissions.
• On August 13, the U.S. District Court of Appeals for the District of Columbia Circuit partially vacated the March 10 preliminary injunction in the cases GHC v. Trump and AVAC v. State Department which required the government to make congressionally appropriated foreign assistance funds available for obligation. The appeals court ruled that the plaintiffs did not have the authority to challenge the President’s impoundment of funds. Instead, the court ruled that challenges of impoundment should be brought forward by the Comptroller General.
• On August 28, the U.S. District Court of Appeals for the District of Columbia Circuit amended its opinion, clarifying that while plaintiffs did not have the authority to challenge impoundment of foreign assistance funds through the Impoundment Control Act, they could seek relief through the Administrative Procedures Act. Following this amended opinion, plaintiffs in GHC v. Trump and AVAC v. State Department cases motioned for a preliminary injunction in the U.S. district court on September 1. On September 3, the U.S. district court granted the preliminary injunction, ordering defendants to obligate expiring foreign assistance funds before the end of the fiscal year on September 30. On September 4, defendants appealed this preliminary injunction and requested a stay on the preliminary injunction pending the resolution of the appeals case, from both the district court and appeals court. These requests were both denied on September 5. On September 8, defendants requested a stay of the preliminary injunction as it pertained to funds included in the President’s proposed rescissions package from the U.S Supreme Court. On September 9, the Chief Justice of the Supreme Court granted a partial administrative stay of the preliminary injunction, and on September 26, the court granted the partial stay.

The 90-day review of foreign assistance was initially supposed to go through April 19, 2025, however, has been granted a 30-day extension.
America First Policy Directive To The Secretary Of State, January 20, 2025
PURPOSE: To put core American interests first in foreign policy.

The foreign policy of the United States “shall champion core American interests and always put America and American citizens first.”

“As soon as practicable, the Secretary of State shall issue guidance bringing the Department of State’s policies, programs, personnel, and operations in line with an America First foreign policy, which puts America and its interests first.”		What Happens Next/Implications: The State Department is responsible for the supervision and overall strategic direction of foreign assistance programs administered by the State Department and USAID, which includes the vast majority of global health assistance. It also directly oversees PEPFAR, the global HIV/AIDS program, and many aspects of global health diplomacy for the U.S. Priorities and approaches for these and other global health programs are likely to be shaped by how the White House and State Department leadership define “America First” foreign policy and American interests, and how that definition is implemented in practice.

In the President’s Budget Request for FY 2026, the request proposes eliminated funding for several global health activities, including family planning and reproductive health (FPRH), neglected tropical diseases (NTDs), and nutrition, stating these are “programs that do not make Americans safer”. However, Congress will determine final funding levels and whether to include these eliminations in its appropriations bills.

On September 18, the State Department released the America First Global Health Strategy, its new vision for U.S. global health engagement. The strategy is built around three pillars — “making America safer, stronger, and more prosperous” — and prioritizes funding for direct service support, such as commodities and health workers, includes plans for country co-investment, and seeks to transition program management operations from U.S. leadership to country ownership. The State Department states that it aims to enter into multi-year bilateral agreements with those recipient countries who receive most U.S. foreign assistance by December 31, 2025 and to implement these new agreements by April 2026. 
Defending Women From Gender Ideology Extremism And Restoring Biological Truth To The Federal Government, January 20, 2025
PURPOSE: To define sex as an immutable binary biological classification and remove recognition of the concept of gender identity.

• The order states that “It is the policy of the United States to recognize two sexes, male and female” and directs the Executive Branch to “enforce all sex-protective laws to promote this reality”. Elements of the order that may affect global health programs are as follows:
• Defines sex as “an individual’s immutable biological classification as either male or female”.  States that “sex” is not a synonym for and does not include the concept of “gender identity” and that gender identity “does not provide a meaningful basis for identification and cannot be recognized as a replacement for sex.”
• Directs the Secretary of Health and Human Services to provide the U.S. Government, external partners, and the public clear guidance expanding on the sex-based definitions set forth in the order within 30 days.
• Directs each agency and all Federal employees to “enforce laws governing sex-based rights, protections, opportunities, and accommodations to protect men and women as biologically distinct sexes, including when interpreting or applying statutes, regulations, or guidance and in all other official agency business, documents, and communications.
• Directs each agency and all Federal employees, when administering or enforcing sex-based distinctions, to use the term “sex” and not “gender” in all applicable Federal policies and documents.
• Directs agencies to remove all statements, policies, regulations, forms, communications, or other internal and external messages “that promote or otherwise inculcate gender ideology”, and shall cease issuing such statements, policies, regulations, forms, communications or other messages. Directs agencies to take all necessary steps, as permitted by law, to end the Federal funding of gender ideology.
• Requires that Federal funds shall not be used to promote gender ideology and directs agencies to ensure grant funds do not promote gender ideology.
• Rescinds multiple executive orders issued by President Biden, including: “Preventing and Combating Discrimination on the Basis of Gender Identity or Sexual Orientation” (13988) and “Advancing Equality for Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex Individuals” (14075).		What Happens Next/Implications: This order is broad, directed to all federal agencies and programs. Because PEPFAR, and some other U.S. global health programs, serve people who are members of the LGBTQ community, guidance and implementation could affect the ability of these programs to reach individuals and organizations and provide them with services. In addition, the order will likely result in the removal of existing protections based on sexual orientation and gender identity, which had been provided in agency guidance for global health and development programs. Implementation guidance has been issued and all federal agencies must comply.
Memorandum For The Secretary Of State, The Secretary Of Defense, The Secretary Of Health And Human Services, The Administrator Of The United States Agency For International Development, January 24, 2025
PURPOSE: To reinstate Mexico City Policy and direct review of programs per the Kemp-Kasten Amendment.

• Revokes President Biden’s Presidential Memorandum of January 28, 2021 for the Secretary of State, the Secretary of Defense, the Secretary of Health and Human Services, and the Administrator of the United States Agency for International Development (Protecting Women’s Health at Home and Abroad).
• Reinstates President Trump’s Presidential Memorandum of January 23, 2017 for the Secretary of State, the Secretary of Health and Human Services, and the Administrator of the United States Agency for International Development (The Mexico City Policy).
• Directs the Secretary of State, in coordination with the Secretary of Health and Human Services, to the extent allowable by law, to implement a plan to extend the requirements of the reinstated Memorandum to global health assistance furnished by all departments or agencies.
• Directs the Secretary of State to take all necessary actions, to the extent permitted by law, to ensure that U.S. taxpayer dollars do not fund organizations or programs that support or participate in the management of a program of coercive abortion or involuntary sterilization.		What Happens Next/Implications: The Mexico City Policy is a U.S. government policy that – when in effect – has required foreign NGOs to certify that they will not “perform or actively promote abortion as a method of family planning” using funds from any source (including non-U.S. funds) as a condition of receiving U.S. global family planning assistance and, when in place under the Trump administration, most other U.S. global health assistance. First announced in 1984 by the Reagan administration, the policy has been rescinded and reinstated by subsequent administrations along party lines since; it was widely expected that the President Trump would reinstate it in his second term. The new memorandum calls for the implementation of a plan to extend the requirements to global health assistance furnished by all departments or agencies; until the plan is ready, the scope of the new memorandum is unknown.

The new memorandum also directs the Secretary of State to review programs under the Kemp-Kasten amendment, a provision of U.S. law that states that no U.S. funds may be made available to “any organization or program which, as determined by the [p]resident of the United States, supports or participates in the management of a program of coercive abortion or involuntary sterilization.” It has been used in the past to prevent funding from going to UNFPA.

See: KFF Mexico City Policy explainer and related resources and Kemp-Kasten explainer.
Renewed Membership in the Geneva Consensus Declaration on Promoting Women’s Health and Strengthening the Family, January 24, 2025
PURPOSE: To rejoin the Geneva Consensus Declaration.

The United States informed signatories of the Geneva Consensus Declaration of its intent to rejoin immediately. Established in 2020, the declaration, led by the United States, has the following objectives: “to secure meaningful health and development gains for women; to protect life at all stages; to defend the family as the fundamental unit of society; and to work together across the UN system to realize these values.”

What Happens Next/Implications: The Geneva Consensus Declaration, initially crafted and signed by the U.S. – along with 31 other countries at the time – was meant to enshrine certain values and principles related to women’s health and family, including a rejection of the “international right to abortion.”  The Biden administration withdrew from the Consensus in 2021.
Review of and Changes to USAID, January 27, 2025
Reorganization of the Department of State, April 22, 2025
PURPOSE: To review and potentially reorganize USAID “to maximize efficiency and align operations with the national interest,” which may include the suspension or elimination of programs, projects, or activities; closing or suspending missions or posts; closing, reorganizing, downsizing, or renaming establishments, organizations, bureaus, centers, or offices; reducing the size of the workforce at such entities; and contracting out or privatizing functions or activities performed by federal employees.What Happens Next/Implications: Related to but separate from the Executive Order on reevaluating and realigning foreign aid and on the America first policy directive to the Secretary of State, the administration has made changes to and begun a review of USAID, the U.S. government’s international development agency which oversees and/or implements most U.S. global health programs (see, The U.S. Government and Global Health). Key developments are as follows:
• On January 27, senior USAID career staff were placed on leave and hundreds of other staff were let go.
• On February 2, the USAID website was taken down.
• On February 3, the USAID building in DC was closed, which has prevented other staff from accessing it.
• The President appointed Secretary of State Rubio as Acting USAID Administrator on February 3. Secretary Rubio has said that the agency has “conflicting, overlapping, and duplicative functions that it shares with the Department of State” and that its systems and processes are not “well synthesized, integrated, or coordinated, and often result in discord in the foreign policy and foreign relations of the United States.” President Trump and other administration officials have called for dissolving the agency altogether. Formal notification of the intent to review the agency was sent by Secretary Rubio to Congress on February 3.
• On February 4, a notice was posted on the USAID website stating that on February 7, all USAID direct hire personnel would be placed on administrative leave globally, with the exception of “designated personnel responsible for mission­ critical functions, core leadership and specially designated programs.” The notice also said that staff posted outside the United States would need to return to the U.S. within 30 days.
• On February 6, a lawsuit was filed by Democracy Forward and Public Citizen Litigation Group, on behalf of the American Foreign Service Association and American Federation of Government Employees, challenging the foreign aid funding freeze, the plan to put most staff on leave, and the fact that staff had already been placed on leave; on February 7, they filed for a temporary restraining order (TRO). That same day, a temporary restraining order was issued by the U.S. District Court in the District of Columbia preventing the government from placing additional staff on leave or evacuating staff back to the U.S., and requiring reinstatement of all staff already placed on leave, until February 14. The court did not grant a TRO on the funding freeze, on the grounds that the plaintiffs in this case did not demonstrate that the freeze caused them irreparable harm. On February 13, the court extended the TRO through February 21, at which time, the court determined that further preliminary injunctive relief was not warranted and the TRO was ended, allowing the government to dismiss USAID staff.
• On February 11, a lawsuit was filed in the U.S. District Court for the District of Columbia on behalf of several U.S. organizations challenging the executive order pausing foreign aid, and subsequent actions freezing foreign aid and dissolving USAID, and asking the court to temporarily restrain and preliminarily and permanently enjoin Defendants from implementing these actions. In a February 13 ruling, a federal court issued a TRO preventing the Trump administration from freezing foreign aid assistance but stated that the proposed injunctions related to USAID were overbroad (in a separate case, the district court ended the TRO on dismissing USAID staff – see above).
• On February 13, a lawsuit was filed in the U.S. District Court for the District of Maryland by 26 former and current employees of USAID, suing Elon Musk and DOGE for taking actions to control and dissolve the agency. On February 18, the plaintiffs filed a motion for preliminary injunction. The defendants responded on February 24 and the plaintiffs replied on February 26. On March 18, the court granted a preliminary injunction, requiring the defendants to reverse many of the actions taken to dissolve USAID, and on March 21, the defendants filed an appeal on the preliminary injunction. On March 25, the U.S. 4th Circuit Court of Appeals granted the defendants’ motion for a temporary stay on the preliminary injunction, allowing DOGE to resume its efforts to dissolve USAID, until March 27. The following day on March 28, the court granted defendants’ motion for a stay, clearing the path for DOGE to continue its work dissolving USAID.
• On February 18, a lawsuit was filed in the U.S. District Court for the District of Columbia on behalf of the Personal Services Contractor Association (representing USAID personal service contractors) challenging the suspension of foreign assistance and the actions related to USAID, including “steps to dismantle USAID, cripple its operations, or transfer its functions to the State Department without Congressional authorization”. On February 19, the plaintiffs filed a motion for a temporary restraining order. On March 6, the court denied the TRO request.
• On March 28, Secretary Rubio announced that the Department of State and USAID have notified Congress on their intent to “undertake a reorganization that would involve realigning certain USAID functions to the Department by July 1, 2025, and discontinuing the remaining USAID functions that do not align with Administration priorities.” Additionally, nearly all the remaining USAID staff received notice that they would be subject to a final reduction-in-force.
• On April 22, Secretary Rubio announced the Department of State’s reorganization plan and new organization chart. The plan states that it would consolidate functions and remove non-statutory programs that are “misaligned with America’s core national interests.”
• On April 28, a lawsuit was filed by a group of labor unions, non-profits, and local governments challenging the administration’s moves to drastically reshape several federal agencies without congressional approval (American Federation of Government Employees v. Trump). The district court issued a TRO on May 9 and preliminary injunction on May 22 ordering the administration to pause large-scale reductions in force, program eliminations, and other actions related to federal agency restructuring. An emergency motion by the government for a stay pending appeal of the district court’s preliminary injunction was denied on May 30.
• On May 2 and May 30, the White House released information on its budget request for FY 2026, noting the reorganization of USAID into the Department of State.
• On May 29, the Department of State notified Congress of its reorganization plans, including absorbing USAID’s continued functions.
• On June 13, the district court in American Federation of Government Employees v. Trump ruled that the actions of the Department of State, including the reorganization announcement and notification to Congress, were in violation of the preliminary injunction.
• On July 8, the U.S. Supreme Court granted the government’s request for a stay of the preliminary injunction pending resolution of the appeals case in American Federation of Government Employees v. Trump, allowing the government to move forward with large-scale reductions to federal agency operations and workforces, including at the State Department.

While initially created through Executive Order in 1961 as part of the State Department, the Foreign Affairs Reform and Restructuring Act of 1998 established it as an independent agency within the executive branch. As such, the Executive branch does not have authority to dissolve it without Congress, and Congress also requires notification first as well as consultation on any proposed changes.
Withdrawing the United States From and Ending Funding to Certain United Nations Organizations and Reviewing United States Support to All International Organizations, February 4, 2025
PURPOSE: To review United States participation in all international intergovernmental organizations, conventions, and treaties and to withdraw from and end funding to certain United Nations (U.N.) organizations.

• The U.S. “helped found” the U.N. “after World War II to prevent future global conflicts and promote international peace and security.  But some of [its] agencies and bodies have drifted from this mission and instead act contrary to the interests of the United States while attacking our allies and propagating anti-Semitism.”
• States that the U.S. “will reevaluate our commitment to these institutions,” including three organizations that “deserve renewed scrutiny”:
a) the U.N. Human Rights Council (UNHRC; the U.S. will not participate in and withhold its contribution to the budget of the body),
b) the U.N. Educational, Scientific, and Cultural Organization (UNESCO; the U.S. will conduct a review of its membership in the body within 90 days), and
c) the U.N. Relief and Works Agency for Palestine Refugees in the Near East (UNRWA; reiterates that the U.S. will not contribute to the body).
• Requires that within 180 days:
a) the Secretary of State, with the U.S. Ambassador to the U.N., conduct a review of all international intergovernmental organizations of which the U.S. is a member and provides any type of funding or other support, and all conventions and treaties to which the United States is a party, to determine which organizations, conventions, and treaties are contrary to the interests of the United States and whether such organizations, conventions, or treaties can be reformed; and
b) the Secretary of State to report the findings of the review to the President, through the National Security Advisor, and provide recommendations as to whether the U.S. should withdraw from any such organizations, conventions, or treaties.		What Happens Next/Implications: With a long history of multilateral global health engagement, the U.S. is often the largest or one of the largest donors to multilateral health efforts (i.e., multi-country, pooled support often directed through an international organization). It provided $2.4 billion in assessed or core contributions in FY 2024 – 19% of overall U.S. global health funding – as well as more funding in voluntary or non-core contributions.

The U.S. is also a signatory or party to numerous global health-related international conventions, treaties, and agreements; these include those that played a role in the global COVID-19 response (such as the International Health Regulations). It often has participated in negotiations for new international instruments, although the Trump administration indicated in a Jan. 20, 2025, Executive Order, listed above, that the U.S. would no longer engage in the Pandemic Agreement (sometimes called the “Pandemic Treaty”) negotiations.

This Executive Order will have immediate impacts via the ordered actions related to the three U.N. organizations specified, much as the impacts of the Jan. 20, 2025, Executive Order on the World Health Organization (WHO, which initiated U.S. withdrawal from membership and halted U.S. funding) are already being seen. Beyond these, additional impacts of this Executive Order will be determined by the findings and recommendations of the international organizations and conventions review, particularly if U.S. support for or membership in some international organizations is recommended to be reduced or eliminated and if it recommends the U.S. withdraw from any international agreements.

Congressional notification and oversight of any proposed changes will also be important to watch, including debates about whether advice or consent or congressional notification periods are or may be required prior to withdrawing the U.S. from international instruments such as treaties.

The administration has already signaled plans to discontinue support for several international organizations in its budget request for FY 2026 by proposing eliminated funding for Gavi, the Pan American Health Organization (PAHO), the United Nations Children’s Fund (UNICEF), the United Nations Population Fund (UNFPA), and the World Health Organization (WHO). However, Congress will determine final funding levels and whether to include these eliminations in its appropriations bills.

The 180 day review of all international intergovernmental organizations goes through August 3, 2025.
Memorandum For The Heads Of Executive Departments And Agencies, February 6, 2025
PURPOSE: The memorandum seeks to “stop funding Nongovernmental Organizations that undermine the national interest and administration priorities”.

The memorandum:

• States: it is Administration policy “to stop funding NGOs [Nongovernmental Organizations] that undermine the national interest.”
• Directs heads of executive departments and agencies to review all funding that agencies provide to NGOs and “to align future funding decisions with the interests of the United States and with the goals and priorities of my Administration, as expressed in executive action; as otherwise determined in the judgment of the heads of agencies; and on the basis of applicable authorizing statues, regulations, and terms.”		What Happens Next/Implications: This memo aligns with other Executive actions that target federal funding for global health and foreign assistance programs. Implementation of this memo could result in the Administration halting funding to global health NGOs they determine “do not align with administration priorities.” No criteria for how this determination will be made has been provided.

The majority of U.S. global health assistance is channeled through NGOs. In FY22, for example, 62% of U.S. global health funding was provided to NGOs as prime partners (45% to U.S.-based NGOs and 17% to foreign-based NGOs) and others are likely sub-recipients of U.S. assistance.* As such, this Order could have a significant impact on NGOs if it is determined that they do not align with administration policies.

*Source: KFF analysis of data from www.foreignassistance.gov.
Addressing Egregious Actions of The Republic of South Africa, February 7, 2025
PURPOSE: To stop U.S. support for South Africa due to its “commission of rights violations in its country or its ‘undermining United States foreign policy, which poses national security threats to our Nation, our allies, our African partners, and our interests.”

“It is the policy of the United States that, as long as South Africa continues these unjust and immoral practices that harm our Nation:
(a)  the United States shall not provide aid or assistance to South Africa; and
(b)  the United States shall promote the resettlement of Afrikaner refugees escaping government-sponsored race-based discrimination, including racially discriminatory property confiscation.”

ACTIONS:

• All executive departments and agencies, including USAID, shall, to the maximum extent allowed by law, halt foreign aid or assistance delivered or provided to South Africa, and shall promptly exercise all available authorities and discretion to halt such aid or assistance.
• The head of each agency may permit the provision of any such foreign aid or assistance that, in the discretion of the relevant agency head, is necessary or appropriate.
• The Secretary of State and the Secretary of Homeland Security shall take appropriate steps, consistent with law, to prioritize humanitarian relief, including admission and resettlement through the United States Refugee Admissions Program, for Afrikaners in South Africa. A plan shall be submitted to the President through the Assistant to the President and Homeland Security Advisor.		What Happens Next/Implications: South Africa receives a significant amount of global health assistance, particularly for HIV/AIDS, from the United States government. The executive order allows the heads of U.S. agencies to permit the provision of foreign aid or assistance under this order at their discretion. On February 10, the U.S. Embassy and Consulates in South Africa announced that PEPFAR would not be impacted by this Executive Order and could continue under the limited waiver already granted to the foreign aid funding freeze. No other exceptions have yet been announced.

The Government of South Africa has issued a statement in response to the Executive Order that, among other things, expresses concern “by what seems to be a campaign of misinformation and propaganda aimed at misrepresenting our great nation.”

Notes and Sources:

*There are several other Executive Actions issued by the President that instruct all government agencies on a variety of topics and as such broadly affect global health program operations but are not specific to global health. These include, for example, Executive Actions withdrawing from the Paris Agreement under the United Nations Framework Convention on Climate Change and ending DEI programs. These are not included in this resource.

Sources: White House, https://www.whitehouse.gov/presidential-actions/; State Department, www.state.gov.

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Poll Finding

KFF Health Tracking Poll: Public Use and Trust in Health Care Apps and Websites

Published: Oct 24, 2025
Section:
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Findings

Key Takeaways

  • There is widespread use of health care apps or websites to manage individuals’ health care with about three in four adults in the U.S. saying they have used a health care app or website in the past year, including majorities of adults regardless of income, education, race and ethnicity, and where they live. The most common use of these health care apps includes getting test and lab results, making appointments, and managing prescriptions or medications. This includes health care apps managed by a health provider like MyChart or other online patient portals for doctors, hospitals, or insurance companies, but does not include personal fitness or wellness apps used to track health and wellbeing.
  • About eight in ten adults ages 65 and older with Medicare say they have used a health care app or website in the past year, and the large majority say using these tools made it easier to manage their health care. This may be seen as encouraging sign for the “Make Health Tech Great Again” initiative announced by President Trump and CMS Director Dr. Oz announced earlier this year, which aims to partner with dozens of companies to increase the availability and use of digital health tools, including apps. But one in ten older adults with Medicare say that these digital health tools make managing their care more difficult.
  • A majority of older adults with Medicare say it should be at least an important priority for Medicare to make it easier to securely share information between different providers (81%) and increase the availability of apps that help manage chronic conditions with a health care provider (63%). However, few say that either of these items should be a top priority for Medicare. Instead, majorities call it important, but not a top priority.
  • While use of health care apps is common and most find them helpful in managing their care, the public is still very worried about privacy and many are cautious about the use of artificial intelligence, or AI. Majorities of adults express concerns about the privacy of their health information, regardless of whether the app is managed by the government (78%), a private technology company (75%), or a health insurance company (64%). Fewer, or about half (52%), are concerned about the privacy of their information if the app is managed by a hospital or other health care provider. Less than half of the public say they would trust a health care app that used AI to manage their health care (41%) or access their medical records and provide personalized health information or advice (32%).

Use of Digital Tools in the Health Care System

About eight in ten of the public say they have ever used a health care app or website to manage their health care, including three in four who say they have done so in the past year. This includes at least six in ten adults across education, income, race and ethnicity, and age groups. But the recent rate of uptake does vary somewhat within demographic groups. For example, eight in ten White adults say they’ve ever used an online tool to manage their health care in the past year, compared to seven in ten Black adults, and about two-thirds of Hispanic adults.  Education and income are also factors in recent use of health care apps or websites, with smaller shares of those with lower incomes and less than a college degree reporting they’ve ever used these online tools to manage their health care. Use of these digital health tools is widespread across age groups, with at least seven in ten saying they’ve ever used a health care app or website to manage their care and at least two-thirds having done so in the past year. In addition, use of health care apps does not vary depending on where people live, with large majorities of people living in urban areas (76%), suburban areas (79%), and rural areas (78%) reporting ever using such apps.

Most Adults Across Demographics Say They Have Used a Health Care App or Website To Manage Their Health Care

Most commonly, seven in ten (71%) adults say they have used a health care app or website in the past year to access their medical records or lab test results, followed by about six in ten adults who have used an app or website to make an appointment with a doctor or health care provider (61%) or manage prescriptions (59%). More than half of adults (55%) have used an app or website in the last year to send a direct message to their doctor or other health care provider. Less common are using apps or websites to file claims or pay bills from either their health insurance company or provider (46%), to have video appointments with their doctor (35%), or to manage a chronic condition like diabetes or obesity with their doctor (21%).

Accessing Medical Records or Lab Results Is the Most Common Use of Health Care Apps or Websites

Health Care App and Website Use Among Older Adults with Medicare

In late July, the Trump administration announced plans to build a “smarter, more secure, and more personalized healthcare experience.” This announcement came off the back of a “Make Health Tech Great Again” meeting at the White House, where the Centers for Medicare and Medicaid Services (CMS) secured commitments from healthcare and technology firms that will partner with the government to create better health technology, especially for those with government insurance. Among the technology groups to partner with the administration is OpenAI, with plans to add AI assistance to technology improvements.

Three quarters of adults with Medicare ages 65 and older say they’ve used an online tool to access their medical records or lab results in the last year. About six in ten older adults with Medicare say they’ve used a health care app or website to manage prescriptions or medications (62%), sent a direct message to their doctor or health care provider (57%), or made an appointment with a doctor or health care provider (55%). Just under half (45%) of older adults with Medicare have used an online tool to file claims or pay bills from their insurance company and provider in the last year. Smaller shares say they’ve used a health care app or website to have a video appointment with their doctor or health care provider in the last year (30%) or used it to manage chronic conditions like diabetes or obesity with their doctor or health care provider (23%).

Accessing Medical Records and Managing Prescriptions or Medications Are Among the Top Uses of Health Care Apps or Websites Among Older Adults With Medicare

Overall, two-thirds (65%) of the public say using health care apps and websites has made managing their health care easier, while one in ten say it makes no difference (8%). Few (5%) say that using these online tools makes managing their health care more difficult. Around one in five adults overall have never used these tools.

Notably, about one in ten (8%) Medicare enrollees ages 65 and older report that using these online tools makes it more difficult to manage their health care, while two in ten (21%) have never used these tools.

Majorities Across Insurance Coverage Types Say Health Care Apps, Websites, or Online Portals Make Managing Their Health Easier

How Older Adults with Medicare See Technology as a Priority for CMS

A majority of older adults with Medicare say it is important for Medicare to prioritize aspects of app or website development for health care delivery, but few say it should be a top priority for the agency. Eight in ten (81%) say it is at least an important priority that Medicare makes it easier to securely share health information between different health care providers, and about two thirds (63%) say it’s at least an important priority that Medicare increases availability of apps that help manage chronic conditions like diabetes or obesity with the help of a health care provider.

Even though majorities say that it is at least important, few older adults with Medicare say that these are a top priority for them, including a quarter (27%) who say making it easier to share health information between providers is a top priority and one in ten (12%) who say increasing availability of apps to manage chronic conditions is a top priority.  About half of adults ages 65 and older with Medicare say each is important, but not a top priority. On the other hand, three in ten say increasing availability of apps to manage chronic conditions is not too important and 6% say it shouldn’t be done, while one in seven (14%) say making it easier to securely share health information is not too important and 5% say it shouldn’t be done.

Among the public overall, these shares are similar across partisanship, with majorities of Republicans and Democrats saying each of these is at least an important priority for Medicare but smaller shares seeing them as top priorities.

Many Older Adults With Medicare Say It Is Important for Medicare To Make Advancements in Digital Health, but Few Say It Is a Top Priority

One of the purposes noted by CMS in creating this digital health ecosystem is to reduce the number of apps that people have to use to access their health information. Half (51%) of people who have ever used health care apps, including 55% of those with Medicare ages 65 and older, report that they use multiple apps, websites, or accounts to manage their health care.

Most people who use multiple apps say they find it “very” or “somewhat easy” to keep track of the multiple sources, including 72% of Medicare enrollees ages 65 and older. However, three in ten adults and a similar share of older Medicare enrollees (28%) say they find it either “somewhat” or “very difficult” to manage multiple apps or websites.

More Than a Quarter of People Who Have To Use Multiple Apps To Manage Health Care Find It Difficult To Navigate

Privacy Concerns and AI

Majorities of adults are concerned about the privacy of their information when using a health care-related app, regardless of who manages it. About eight in ten (78%) say they would be “very” or “somewhat” concerned about the privacy of their information when using a health care related app managed by the government, with similar shares saying so if the app was managed by a private technology company (75%). Two-thirds (64%) would be concerned about the privacy of their information if the app was managed by a health insurance company. Fewer – about half (52%) – say the same if the app was managed by a hospital or other health care provider.

Most Would Be Concerned About Privacy on Health Care-Related Apps, No Matter the Manager

Privacy concerns are pervasive across party, with majorities across partisanship saying they would be concerned about the privacy of their information on a health care related app managed by the government, a private technology company, or a health insurance company. Republicans, independents, and Democrats are less concerned about privacy issues if the app is run by a hospital or other health care provider but still a slight majority of independents and Republicans are concerned. A majority of adults, regardless of age, are concerned about the privacy of their information if the app is managed by the government, private technology companies, or an insurance company.

Partisans Agree on Privacy Concerns for Most App Managers, but Differ When the Manager Is a Hospital or Health Care Provider

Part of CMS’s vision for modernizing America’s health care technology system involves supporting health care apps that utilize artificial intelligence (AI). However, the public isn’t quite convinced that AI can help manage their health care or provide personalized health information. Less than half of the public (41%) say they would have a “great deal” or “fair amount” of trust in a health care app, website, or online patient portal that uses an AI chatbot to make appointments or send messages to their doctors. An even smaller share, about one in three adults (32%), say they would trust an online health tool that uses AI to access their medical records to provide personalized health information. Very few would trust a health tool that uses AI “a great deal” to do either of these tasks, with just under one in ten trusting AI chatbots to manage their care or to access their medical records (8% for each).

Notably, the level of trust in AI does not vary across age groups with less than half regardless of age saying they trust AI to manage their care or provide personalized health information, though older adults are somewhat more likely than younger adults to say they don’t know enough to say whether they would trust online health tools that use AI to help manage their health care.

Few Adults Express High Levels of Trust in AI for Making Appointments or Providing Personalized Health Information

Methodology

This KFF Health Tracking Poll/KFF Tracking Poll on Health Information and Trust was designed and analyzed by public opinion researchers at KFF. The survey was conducted September 23-29, 2025, online and by telephone among a nationally representative sample of 1,334 U.S. adults in English (n=1,255) and in Spanish (n=79). The sample includes 1,026 adults (n=64 in Spanish) reached through the SSRS Opinion Panel either online (n=1,004) or over the phone (n=22). The SSRS Opinion Panel is a nationally representative probability-based panel where panel members are recruited randomly in one of two ways: (a) Through invitations mailed to respondents randomly sampled from an Address-Based Sample (ABS) provided by Marketing Systems Groups (MSG) through the U.S. Postal Service’s Computerized Delivery Sequence (CDS); (b) from a dual-frame random digit dial (RDD) sample provided by MSG. For the online panel component, invitations were sent to panel members by email followed by up to three reminder emails.

Another 308 (n=15 in Spanish) adults were reached through random digit dial telephone sample of prepaid cell phone numbers obtained through MSG. Phone numbers used for the prepaid cell phone component were randomly generated from a cell phone sampling frame with disproportionate stratification aimed at reaching Hispanic and non-Hispanic Black respondents. Stratification was based on incidence of the race/ethnicity groups within each frame. Among this prepaid cell phone component, 141 were interviewed by phone and 167 were invited to the web survey via short message service (SMS).

Respondents in the prepaid cell phone sample who were interviewed by phone received a $15 incentive via a check received by mail. Respondents in the prepaid cell phone sample reached via SMS received a $10 electronic gift card incentive. SSRS Opinion Panel respondents received a $5 electronic gift card incentive (some harder-to-reach groups received a $10 electronic gift card). In order to ensure data quality, cases were removed if they failed two or more quality checks: (1) attention check questions in the online version of the questionnaire, (2) had over 30% item non-response, or (3) had a length less than one quarter of the mean length by mode. Based on this criterion, no cases were removed.

The combined cell phone and panel samples were weighted to match the sample’s demographics to the national U.S. adult population using data from the Census Bureau’s 2024 Current Population Survey (CPS), September 2023 Volunteering and Civic Life Supplement data from the CPS, and the 2025 KFF Benchmarking Survey with ABS and prepaid cell phone samples. The demographic variables included in weighting for the general population sample are gender, age, education, race/ethnicity, region, civic engagement, frequency of internet use, and political party identification. The weights account for differences in the probability of selection for each sample type (prepaid cell phone and panel). This includes adjustment for the sample design and geographic stratification of the cell phone sample, within household probability of selection, and the design of the panel-recruitment procedure.

The margin of sampling error including the design effect for the full sample is plus or minus 3 percentage points. Numbers of respondents and margins of sampling error for key subgroups are shown in the table below. For results based on other subgroups, the margin of sampling error may be higher. Sample sizes and margins of sampling error for other subgroups are available on request. Sampling error is only one of many potential sources of error and there may be other unmeasured error in this or any other public opinion poll. KFF public opinion and survey research is a charter member of the Transparency Initiative of the American Association for Public Opinion Research.

GroupN (unweighted)M.O.S.E.
Total1,334± 3 percentage points
   
Party ID  
Democrats418± 6 percentage points
Independents455± 6 percentage points
Republicans385± 6 percentage points
   
MAGA Republicans374± 6 percentage points
MAHA supporters583± 5 percentage points

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Related Content

VOLUME 33

KFF/Washington Post Poll Looks at Parents’ Trust in Children’s Health Content on Social Media, And Unfounded Claims About Abortion Pill Safety Follow FDA Approval of Generic Version

Irving Washington , Hagere Yilma , and Joel Luther

Summary

This volume highlights the latest release from the KFF/The Washington Post Survey of Parents, which finds that most parents report seeing children’s health content on social media, but many are unsure how to evaluate the trustworthiness of advice shared by health and wellness influencers. It also reviews misleading claims about the safety of medication abortion following the approval of a generic version of the abortion pill mifepristone, and it explores reports that federal officials are considering adding autism to the list of conditions covered by the Vaccine Injury Compensation Program. Lastly, it examines the use of AI chatbots by patients seeking to interpret lab results.

Featured: KFF/Washington Post Survey of Parents Finds Most Parents See Children’s Health Content on Social Media and Many Are Unsure What to Trust

The latest release from the KFF/Washington Post Survey of Parents finds that eight in ten parents say they see information or advice about children’s health at least occasionally on social media, including about three in ten who say they see this information daily or weekly. One-third (36%) of parents ages 18 to 34 say they see this content at least weekly compared to fewer parents ages 35-49 (28%) or those 50 and older (22%).

Three in Ten Parents See Information About Children's Health On Social Media At Least Weekly, Including Larger Shares of Younger Parents

Even though most parents say they see children’s health content on social media, very few can name a specific influencer they trust for this content. One in seven (15%) parents say they trust a particular influencer for information and advice about children’s health, though just 4% can name the influencer. Parents are also largely split on their ability to discern whether content from influencers is trustworthy. About a third (35%) say it is easy to know what advice to trust when it comes from health and wellness influencers on social media, while about four in ten (38%) say it is difficult and another quarter (27%) say they don’t see such content.

Parents Are Split on Whether It Is Easy or Difficult To Know What Advice To Trust From Health Influencers

When it comes to vaccine-related content specifically, one-third of parents say they have ever seen information or advice about children’s vaccines on social media, including similar shares who say most of the content they see is “pro-vaccine” (8%) and “anti-vaccine” (7%), with one in five (19%) saying they see a mix of both.

Recent Developments

Misleading Claims About Abortion Pill Safety Follow FDA Approval of Generic Version of Mifepristone

Photo of a person in a yellow sweater holding a capsule in their hand
MementoJpeg / Getty Images
What’s Happening?

Claims questioning the safety of the abortion drug mifepristone have circulated online following the Food and Drug Administration’s (FDA) approval of a second generic version of the drug. Mifepristone has been approved by the FDA for 25 years with an extensive safety record supported by peer-reviewed research, but the approval drew renewed attention to misleading narratives about its safety spread by lawmakers and officials who oppose abortion. The surprise decision to approve a second generic version followed a September 19 letter in which Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. and FDA Commissioner Marty Makary pledged to conduct a full safety review of the drug.

What Are Common Themes in Online Conversations?
  • Posts about abortion pills increased on X, Reddit, and Bluesky on October 2, the day news of the approval was first reported. KFF’s monitoring of social media identified 8,959 posts, reposts, and comments mentioning terms relating to medication abortion on that day, up from a daily average of 2,460 over the 30 days prior.
  • Although posts about safety concerns represented a relatively small number of posts about medication abortions, the narrative was amplified by some prominent health officials and elected representatives who oppose abortion, despite mifepristone’s long record of safety and effectiveness. The most-engaged-with post about the safety of medication abortion that day came from Senator Josh Hawley, who has more than 2 million followers on X. The post claimed that evidence shows that abortion medications are dangerous and potentially fatal for the mother, though the post did not cite the alleged evidence supporting this claim.
Why This Matters

Unsupported claims questioning the safety of mifepristone despite extensive data showing the drug’s safety may influence decisions about medication abortion and create unnecessary concern and confusion among people seeking care. Mifepristone has been taken by millions of women and medication abortion currently accounts for nearly two-thirds of U.S. abortions. High-profile statements from government officials raising unfounded safety concerns may create confusion or hesitancy among patients and providers and fuel opposition to the drug when there is no evidence of harm.

What Does The Evidence Say?

Mifepristone has been approved by the FDA for 25 years, and FDA prescribing information notes that serious adverse events have been shown to occur in fewer than 0.5% of patients. Other studies have found similar rates, and major medical organizations, including the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) maintain that the drug is safe.

Reports Suggest HHS May Add Autism to List of Conditions Covered by Vaccine Injury Compensation Program

Photo of a toddler being administered a vaccination
Karl Tapales / Getty Images
What’s Happening?

Reports that federal health officials are considering expanding vaccine injury compensation to include autism may have contributed to increases in online conversations linking vaccines to the condition, despite decades of research showing no association. HHS Secretary Robert F. Kennedy Jr. has reportedly suggested both directly adding autism to the Vaccine Injury Compensation Program (VICP) and broadening definitions of some brain conditions covered by the program.

What is VICP?
  • The National Vaccine Injury Compensation Program is a no-fault alternative to the traditional court  system for vaccine injury claims, designed to compensate families for rare vaccine injuries. The program, which covers most routine vaccines and is funded by a small tax on doses administered, manages a trust fund of about $4 billion. The program includes a list of specific injuries that can be caused by each vaccine, which are presumed to be vaccine-related if they occur within timeframes described in the table.  Autism was excluded from this list after extensive litigation in the early 2000s, when judges appointed to handle vaccine injury cases reviewed test cases representing thousands of claims and found no link between vaccines and autism.
  • Compensation decisions through the program do not always indicate causation. Since 1988, about 60% of compensated cases involved negotiated settlements in which HHS drew no direct conclusions about the cause of injuries.
Why This Matters
  • Physicians and legal scholars have warned that this could lead to a wave of injury claims, potentially bankrupting the program and reinforcing false narratives that link vaccines to autism despite decades of research showing no association.
  • The myth that vaccines cause autism is a long-standing false claim, and despite frequent debunking, KFF polling has found that many parents continue to express uncertainty over whether or not it is true. Adding autism to the list of covered conditions could be used to suggest vaccines cause autism despite scientific evidence to the contrary, further eroding trust in vaccines and federal health authorities. Research suggests autism begins early in pregnancy, not in toddlerhood when most vaccines are given. KFF and The Washington Post’s recent release from the Survey of Parents found that at least one-third of parents said there had been too little research into the causes of autism (44%) or whether there is a link between vaccines and autism spectrum disorder (33%).
What Are People Saying?

News coverage and social media posts, reposts, and comments mentioning both autism and VICP spiked in late September and early October, according to KFF’s monitoring. KFF identified 1,647 posts, reposts, and comments published on X, Reddit and Bluesky on September 27, an increase from a daily average of only 12 from the 90 days prior. Many of the posts with the most engagement were reposts from an account with more than 400,000 followers that falsely claimed VICP had conceded vaccines cause autism. Similarly, the number of news stories mentioning both autism and VICP reached the highest point of the year thus far on October 8, with 86 news stories published that day, compared to a daily average of less than one for the year prior to this date.  

What Does The Evidence Say?

Decades of research have shown no causal relationship between vaccines and autism, and medical organizations like the American Academy of Pediatrics (AAP) have concluded there is no link. A 2013 CDC study, for example, showed that the amount of antigens received from vaccines was the same between children with and without autism, and a 2019 cohort study of over 650,000 children in Denmark found no increased autism risk from receiving the measles, mumps, and rubella (MMR) vaccine.

AI & Emerging Technology

Some Patients Turn to AI Chatbots to Interpret Lab Results

Photo of a vial of blood on top of printed lab results
peepo / Getty Images
What’s Happening?

A recent KFF Health News article detailed the growing trend of patients using artificial intelligence (AI) chatbots like ChatGPT, Claude, and Gemini to interpret their medical test results and records when they cannot quickly reach their doctors for answers. Some patients are uploading lab results, imaging reports, and other medical records to these chatbots to get medical explanations while waiting for physician callbacks or appointments.

How Widespread Is This Practice?

Data on how often patients specifically upload test results is not readily available, but KFF’s August 2024 Tracking Poll found that about one in six adults (17%) reported using AI chatbots at least once a month to find health information and advice, rising to one in four (25%) adults under age 30. Most adults (63%) said they were “not too confident” or “not at all confident” that health information from AI chatbots is accurate, while about a third said they were “very” (5%) or “somewhat confident” (31%) in the accuracy of this information.

Why This Matters

While AI chatbots may help patients understand results and reduce anxiety, physicians and researchers have identified risks of using this technology. One concern is AI “hallucinations,” instances where chatbots generate plausible but factually inaccurate information. Chatbots can present false information with the same tone as accurate information, making errors difficult for non-medical users to detect. These errors can be difficult to detect even for medical professionals. A March study published in BMC Medical Education found that general practice trainees had a mean accuracy of only 55% in detecting AI-generated medical hallucinations.

What Does The Evidence Say?

Research indicates that improved prompting strategies can improve the accuracy of AI-generated responses. An April study in JAMIA Open, for example, found that instructing a chatbot to take on the persona of a clinician improved accuracy, and an August Communications Medicine study showed that including additional safeguards in prompts, like asking the AI to use only clinically validated information, reduced the rate of hallucinations. AI education efforts focusing on how to tailor prompts to receive the most accurate information may improve the usefulness of these tools. Still, these strategies did not eliminate errors entirely, and researchers have recommended that chatbots should be supplementary tools rather than primary sources of health information.

About The Health Information and Trust Initiative: the Health Information and Trust Initiative is a KFF program aimed at tracking health misinformation in the U.S., analyzing its impact on the American people, and mobilizing media to address the problem. Our goal is to be of service to everyone working on health misinformation, strengthen efforts to counter misinformation, and build trust. 

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The Monitor is a report from KFF’s Health Information and Trust initiative that focuses on recent developments in health information. It’s free and published twice a month.

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Support for the Health Information and Trust initiative is provided by the Robert Wood Johnson Foundation (RWJF). The views expressed do not necessarily reflect the views of RWJF and KFF maintains full editorial control over all of its policy analysis, polling, and journalism activities. The data shared in the Monitor is sourced through media monitoring research conducted by KFF.

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Poll Finding

KFF/The Washington Post Survey of Parents: Exposure to and Trust in Children’s Health-Related Information Online

Published: Oct 22, 2025
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Findings

As debates over the safety of childhood vaccines and trust in public health guidance play out in the U.S., findings from the latest KFF/Washington Post Survey of Parents reveal how parents encounter health information on social media and how it may shape their decisions. One-third (34%) of parents say they have seen social media content related to childhood vaccines and about three in ten report seeing children’s health-related content on social media weekly or daily (29%). Notably, many parents find it difficult to discern whether health-related information they see online is trustworthy (38%), and few say there is a particular influencer they trust when it comes to information about children’s health (15%). Regardless, only a small share of parents says children’s vaccine-related information on social media affects them, with 4% saying it has made it easier to make vaccine decisions for their children and another 4% saying it has made these decisions more difficult.

Parents’ Exposure to Children’s Health-Related Content

Many parents report seeing social media content related to children’s health, even if they are not actively seeking it out. About eight in ten (79%) parents say they see information or advice about children’s health at least occasionally, compared to just one in five (21%) who say they never see this content. About three in ten (29%) parents say they see information or advice about children’s health on social media daily (11%) or weekly (18%). About one in ten reports seeing this content about once a month (12%), and about four in ten report seeing it occasionally (38%).

Compared to their counterparts, larger shares of parents under age 35 (36%), mothers (35%), Black parents (33%), Hispanic parents (36%), and Democratic parents (33%) say they see this content at least weekly, even if they are not looking for it.

Three in Ten Parents See Information About Children's Health On Social Media At Least Weekly, Including Larger Shares of Women and Younger Parents

Do Parents Trust Influencers When It Comes to General Health and Wellness Advice?

Some of the health-related content shared on social media comes from influencers, individuals who have a large following on social media and often post about issues of interest. While some social media users follow specific influencers, others may be exposed to posts from influencers they don’t follow, as algorithms promote content likely to interest them. With recent moves from large tech companies to get rid of third party fact checking, assessing the validity of this content can be tricky.

This KFF/Washington Post Survey of Parents shows many parents find it difficult to know what to trust when it comes to health content shared by influencers. While about a third (35%) of parents say it is “very easy” or “somewhat easy” to know what advice to trust when it comes from health and wellness influencers they see on social media, about four in ten (38%) say it is “somewhat difficult” or “very difficult.” This includes between one-third and four in ten parents across gender, age, race, ethnicity, and partisanship that say it is at least “somewhat difficult” to discern whether advice from influencers is trustworthy.

Parents Are Split on Whether It Is Easy or Difficult To Know What Advice To Trust From Health Influencers

About one in seven (15%) parents say there is a particular influencer they trust when it comes to information and advice about children’s health, though just 4% can name the influencer while one in eight (12%) say they can’t remember the influencer’s name. About eight in ten (84%) parents say there is either no particular influencer on social media they trust when it comes to information and advice about children’s health (58%) or that they do not see content from health and wellness influencers (27%).

Of the few parents who were able to name an influencer they trust (4%), the names mentioned include a variety of individuals and social media accounts. Very few influencers were mentioned by more than one parent who responded to the survey, suggesting that the health information parents get from influencers represents a spectrum of quality and viewpoints. While some influencers named (including “Dr. Beachgem10” and “Dr. Lauren Hughes”) appear from their profiles to be practicing medical doctors, many others are celebrities or other personalities without medical credentials.

Few Parents Can Name a Social Media Influencer They Trust for Children’s Health Information and Advice

The share of parents who say they have a particular influencer they trust most when it comes to information and advice about children’s health varies by age, race, ethnicity, and vaccine decisions. Younger parents (21%), Black parents (21%), and Hispanic parents (18%) are more likely than their counterparts to say there is an influencer they trust, though few can name a specific influencer. Parents who report having ever skipped or delayed a vaccine for their children are also more likely than those who have kept their children up to date on vaccines to say there is an influencer they trust for advice about children’s health (20% v. 14%), though few in either group can name the influencer. Similar shares of supporters of the Make America Healthy Again (MAHA) movement (15%) and non-MAHA supporters (15%) also say this.

One in Six Parents Trust a Particular Influencer For Children's Health, Including Larger Shares of Younger Parents and Black Parents

When asked which comes closest to their view, about eight in ten (84%) parents say health influencers are mostly motivated by “financial interests” while 15% say they are mostly motivated by “serving the public interest.” Large majorities of parents across age, race and ethnicity, and partisanship say health influencers are motivated by financial interests, though Black parents and younger parents are more likely than their counterparts to say health influencers are motivated by serving the public good (26% and 19%, respectively) – the same groups who are more likely to say there is a specific influencer they trust when it comes to information and advice about children’s health.

Large Majorities of Parents Across Demographics Say Health Influencers Are Mostly Motivated by Financial Interests Over Serving the Public Interest

Childhood Vaccine-Related Content on Social Media

Childhood vaccine recommendations have been a frequent subject of news coverage since the appointment of HHS Secretary Kennedy, including changes and actions at the state and federal levels. These changes may leave parents with questions, and some may turn to social media for advice.

The KFF/Washington Post Survey of Parents finds one-third (34%) of parents say they have ever seen information or advice about vaccines for children on social media. Notably, nearly half (45%) of parents who have skipped or delayed vaccines for their children aside from COVID-19 or flu say they have seen content related to vaccines for children online, compared to about one-third (32%) of parents who have kept their children up to date who say the same.

Compared to their counterparts, somewhat larger shares of mothers (37%), parents under age 35 (38%), and parents who support the MAHA movement (37%) say they have ever seen information online about children’s vaccines.

One-Third of Parents Say They Have Ever Seen Information About Childhood Vaccines on Social Media, Including Larger Shares of Younger Parents and Mothers

About one in five (19%) parents say they see vaccine content that is a “mix of both” pro- and anti-vaccine, while fewer see content that is “mostly pro-vaccine” (8%) or “mostly anti-vaccine” (7%). Notably, among parents who report skipping or delaying vaccines for their children, similar shares say they see mostly anti-vaccine (12%) or mostly pro-vaccine (10%) content online, and about one in four (24%) report seeing a mix of both.

Democratic parents are more likely to say they see pro-vaccine content online than Republican parents (13% vs. 7%), while similar shares report seeing mostly anti-vaccine content (7% and 8%). About one in seven (15%) Democratic parents and one in five Republican and independent parents see content that is mostly a mix of both.

While MAHA supporters are slightly more likely to say they have ever seen content related to childhood vaccines online, similar shares of MAHA supporters and non-MAHA supporters overall say they see mostly pro-vaccine content or mostly anti-vaccine content.

Few Parents Report Seeing Mostly Pro- or Anti-Vaccine Content on Social Media, Larger Shares Say They See a Mix of Both

As many parents report lack of trust in health and wellness influencers, and amidst the broader confusion and uncertainty the public feels about what is true online, few parents say exposure to content about children’s vaccines has made the decision easier (4%) or harder (4%) to make vaccine decisions for their children. One-quarter (26%) of parents say exposure to childhood vaccine-related information on social media has not made it easier nor more difficult to make decisions about vaccinating their own children.

These shares are similar across parent age, partisanship, race, and ethnicity. Among parents who report skipping or delaying vaccines for their children, 9% say social media content has made their decisions easier, 7% say it has made it harder, and three in ten say it hasn’t made much difference.

Few Parents Say Seeing Childhood Vaccine Content on Social Media Has Made It Easier or Harder To Make Vaccine Decisions

Methodology

This KFF/The Washington Post Survey of Parents was designed and analyzed by public opinion researchers at KFF and The Washington Post. The survey was designed to reach a representative sample of parents or legal guardians of children under the age of 18 in the U.S. The survey was conducted July 18 – August 4, 2025, online among a nationally representative sample of 2,716 parents using the Ipsos KnowledgePanel in English (n=2519) and in Spanish (n=197). KnowledgePanel is a nationally representative probability-based panel where panel members are recruited randomly through invitations mailed to respondents randomly sampled from an Address-Based Sample (ABS) provided by Marketing Systems Groups (MSG) through the U.S. Postal Service’s Computerized Delivery Sequence (CDS). Invitations were sent to panel members by email followed by up to two reminder emails.

All completes were reviewed to ensure respondents were giving the survey adequate attention. Three cases were removed from the data that failed internal quality checks. Most KnowledgePanel respondents received a financial incentive equaling about $1 for their participation in this survey with some harder-to-reach groups receiving about $5 for their participation.

The survey also includes an oversample of parents of children 5 years old and younger (n=1,092) in order to reach a higher rate of responses from parents who are currently making decisions around their child’s vaccines. The full sample was weighted to match the sample’s demographics to the national U.S. parent population using data from the Census Bureau’s 2023 American Community Survey. Weighting parameters included gender, age, education, race/ethnicity, region, metro status, and language proficiency within the Hispanic sample. The sample was also weighted to the total parent population on political party identification using the 2025 KFF Benchmarking Survey.  An additional adjustment was conducted in order to provide estimates from parents living in Texas (n=276) using the 2023 ACS as well as the 2023-2024 Pew Religious Landscape Survey. Both weights take into account differences in the probability of selection, including adjustment for the sample design, within household probability of selection, and the design of the panel-recruitment procedure.

The margin of sampling error including the design effect for the total sample is plus or minus 2 percentage points and plus or minus 3 percentage points for the parents of children under the age of 6. The full Texas sample has a margin of sampling error of plus or minus 7 percentage points. Numbers of respondents and margins of sampling error for key subgroups are shown in the table below. For results based on other subgroups, the margin of sampling error may be higher. Sample sizes and margins of sampling error for other subgroups are available on request. Sampling error is only one of many potential sources of error and there may be other unmeasured error in this or any other public opinion poll. KFF and The Washington Post are charter members of the Transparency Initiative of the American Association for Public Opinion Research.

GroupN (unweighted)M.O.S.E.
Total parents2,716± 2 percentage points
   
Support for Make America Healthy Again (MAHA) movement  
MAHA-supporting parents977± 3 percentage points
Not MAHA-supporting parents1,679± 3 percentage points
   
Party ID  
Democratic parents801± 4 percentage points
Independent/Other party parents1,077± 3 percentage points
Republican parents780± 4 percentage points
MAGA Republican parents498± 5 percentage points
   
Parents by vaccine choice  
Skipped or delayed any childhood vaccines436± 5 percentage points
Kept kids up to date on all childhood vaccines2,264± 2 percentage points

 

 

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Perspectives from Employers on the Costs and Issues Associated with Covering GLP-1 Agonists for Weight Loss

Published: Oct 22, 2025

While more large employers are covering GLP-1 drugs for weight loss, conversations with employers highlight concerns about the cost of these medications. Many of these employers have considered scaling back coverage of GLP-1 agonists for weight loss, or in some cases, employers are adding or strengthening coverage requirements.

This analysis discusses findings from the 2025 KFF Employer Health Benefits Survey, with insights gained from interviews and group discussions with human resources directors and others who manage employer health benefits. These conversations occurred in five focus groups across the United States, covering over one hundred companies employing over a quarter of a million people, held throughout the summer and fall of 2025.

The full analysis and other data on health costs are available on the Peterson-KFF Health System Tracker, an online information hub dedicated to monitoring and assessing the performance of the U.S. health system.

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Annual Family Premiums for Employer Coverage Rise 6% in 2025, Nearing $27,000, with Workers Paying $6,850 Toward Premiums Out of Their Paychecks

More of the Largest Firms Cover GLP-1s for Weight Loss, and Use Is Higher Than Expected; Some May Be Limiting Coverage

Published: Oct 22, 2025

Family premiums for employer-sponsored health insurance reached an average of $26,993 this year, KFF’s annual benchmark health benefits survey of large and smaller employers finds. On average, workers contribute $6,850 annually to the cost of family coverage, with employers paying the rest.

Family premiums are up 6%, or $1,408, from last year, similar to the 7% increase recorded in each of the previous two years. This year’s increase compares to general inflation of 2.7% and wage growth of 4% over the same period.  

Over the past five years, the cumulative increase in family premiums (26%) and in what workers pay toward family premiums (23%) is similar to inflation (23.5%) and wage growth (28.6%).

Many employers may be bracing for higher costs next year, with insurers requesting double-digit increases in the small-group and individual markets on average, possibly foreshadowing big increases in the large-group markets as well. Employers continue to single out drug prices as a factor contributing to higher premiums in recent years.

Among large firms (at least 200 workers), who are more likely to know details of their health insurance costs, more than a third (36%) say prescription drug prices contributed “a great deal” to higher premiums in recent years. Significant shares say the same about coverage for new prescription drugs (22%) as well as the prevalence of chronic disease (30%), higher utilization of services (26%), and hospital prices (22%).

“There is a quiet alarm bell going off. With GLP-1s, increases in hospital prices, tariffs and other factors, we expect employer premiums to rise more sharply next year,” KFF President and CEO Drew Altman said. “Employers have nothing new in their arsenal that can address most of the drivers of their cost increases, and that could well result in an increase in deductibles and other forms of employee cost sharing again, a strategy that neither employers nor employees like but companies resort to in a pinch to hold down premium increases.”

About 154 million Americans under age 65 rely on employer-sponsored coverage, and the 27th annual survey of more than 1,800 employers with at least 10 workers provides a detailed picture of the trends affecting it.

In addition to the full report and summary of findings released today, Health Affairs is publishing an article with select findings online. The article will also appear in its November issue. And a new column from KFF’s Drew Altman discusses the limitations employers face trying to control health care costs and why more sharply rising premiums expected next year could lead to a new wave of rising deductibles.

Biggest Employers Add GLP-1 Coverage for Weight Loss, But Fret about Their Costs

About one in five (19%) of large firms offering health benefits say they cover costly GLP-1 drugs such as Wegovy for weight loss in 2025. A majority (57%) say they do not cover such drugs for weight loss, while about a quarter (24%) are unsure if their largest plan cover them.

Among the biggest firms (those with at least 5,000 workers), 43% now say they cover GLP-1 drugs for weight loss in their largest plan, up from 28% in 2024.

Many employers condition their coverage of these medications, and some require that enrollees take additional steps to address their weight. For example, about a third (34%) of large firms offering these drugs for weight loss require that enrollees meet with a dietician, therapist or other professional, or participate in a lifestyle program, for the drugs to be covered.

Even with such restrictions, the high cost of these drugs worries many employers. Most (59%) of the biggest employers (at least 5,000 workers) offering the drugs for weight loss say their cost has exceeded expectations, and two-thirds (66%) say that they had a “significant” impact on their health plan’s prescription drug spending.

Such factors could lead some employers to reduce or eliminate coverage or add additional restrictions. And while most large employers (44%) say covering GLP-1 drugs is either important or very important to their employees, just 1% of those not already offering coverage say they are “very likely” to do so next year.

A companion report for the Peterson-KFF Health System Tracker based on focus-group conversations highlights how the high costs of covering GLP-1 drugs is leading some employers to change how they cover the drugs, such as tightening utilization controls. Some employers report restricting coverage for enrollees with diabetes.

“Large employers know these new high-priced weight-loss drugs are an important benefit for their workers, but their costs often exceed their expectations,” KFF Senior Vice President and study author Gary Claxton said. “It’s not a surprise that some are rethinking access to the drugs for weight loss.”

More Workers Are in HSA-Qualified Plans as Average Deductible Reaches $1,886

The survey finds nearly three in 10 covered workers (29%) are now enrolled in high-deductible health plans that could be used with a tax-preferred Health Savings Account.

Among workers who face an annual deductible for single coverage, the average this year stands at $1,886, which compares to $1,773 last year. Deductibles are up 17% since 2020 when the average was $1,617.

On average, workers with a deductible at small firms (under 200 workers) face much larger deductibles than workers at larger firms ($2,631 vs. $1,670). More than half (53%) of covered workers at small firms now face a deductible of at least $2,000, and more than a third (36%) face an average single deductible of at least $3,000.

In 2025, nearly three-quarters (72%) face an out-of-pocket maximum of more than $3,000 for single coverage, including one in five (21%) who face an out-of-pocket maximum of more than $6,000.

Coverage for Part-Time and Low-Wage Workers Lags; Medicaid Can Fill Gaps

The survey also highlights some challenges facing part-time and low-wage workers in obtaining health coverage.

Part-time workers generally are not eligible for their employer’s health benefits, with only 27% of large firms and 18% of small firms offering coverage to part-time workers.

A much smaller share of workers is covered by their employer’s health benefits at firms with many low-wage workers (43%) than at firms with few low-wage workers (64%). One third (34%) of small employers that do not offer health benefits say that Medicaid is a “very important” source of coverage for their workers, and another one in five (22%) say Medicaid is “somewhat important.”

The survey also finds that Individual Coverage Health Reimbursement Arrangements (ICHRAs) — a much-hyped option to help workers purchase coverage through the Affordable Care Act (ACA) Marketplaces or elsewhere on the individual market —have not taken off.

Among small firms that don’t offer health benefits, 9% report offering funds to at least one worker to purchase their own coverage, similar to the share who said so last year (11%). Among the rest of non-offering small firms, just 2% say they were “very likely” to offer such assistance to any workers in the next two years. A companion report for the Peterson-KFF Health System Tracker highlights employers’ experience with ICHRA and how this nascent market is taking shape.

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Health Affairs

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