Medicare is the federal health insurance program for 69 million people ages 65 and over and younger adults with long-term disabilities. The program helps to pay for many medical care services, including hospitalizations, physician visits, and prescription drugs, along with post-acute care, skilled nursing facility care, home health care, hospice care, and preventive services.

People with Medicare may choose to receive their Medicare benefits through traditional Medicare or through a Medicare Advantage plan, such as a health maintenance organization (HMO) or preferred provider organization (PPO), administered by a private health insurer. People who choose traditional Medicare can sign up for a separate Medicare Part D prescription drug plan for coverage of outpatient prescription drugs and may also consider purchasing a supplemental insurance policy (Medigap) to help with out-of-pockets costs if they do not have additional coverage from a former employer, union, or Medicaid. People who opt for Medicare Advantage can choose among dozens of Medicare Advantage plans, which include all services covered under Medicare Parts A and B, and typically include Part D prescription drug coverage as well.

Each year, Medicare beneficiaries have an opportunity to make changes to how they receive their Medicare coverage during the nearly 8-week annual open enrollment period. This brief answers key questions about the Medicare open enrollment period and Medicare coverage options.

1. When is the Annual Medicare Open Enrollment Period?

The annual Medicare open enrollment period runs from October 15 to December 7 each year (Figure 1). During this time, people with Medicare can review features of Medicare plans offered in their area and make changes to their Medicare coverage, which go into effect on January 1 of the following year. These changes include switching from traditional Medicare to a Medicare Advantage plan (or vice versa), switching between Medicare Advantage plans, and electing or switching between Medicare Part D prescription drug plans.

2. What Changes Can Medicare Beneficiaries Make During the Annual Open Enrollment Period?

People in traditional Medicare can use the Medicare open enrollment period to enroll in a Medicare Part D prescription drug plan or switch between Part D plans. Traditional Medicare beneficiaries who did not sign up for a Part D plan during their initial enrollment period for Medicare can enroll in a Part D plan during the annual open enrollment period, though they may be subject to a late enrollment penalty if they did not have comparable prescription drug coverage from another plan before signing up for Part D. Traditional Medicare beneficiaries with Medicare Parts A and B can also use this time to switch from traditional Medicare into a Medicare Advantage plan, with or without Part D coverage.

People who are enrolled in a Medicare Advantage plan can use the Medicare open enrollment period to choose a different Medicare Advantage plan or switch to traditional Medicare. Medicare Advantage enrollees who switch to traditional Medicare can enroll in a Part D plan if they want outpatient prescription drug coverage, which is not covered under Medicare Parts A and B. (Beneficiaries may be subject to late enrollment penalties if they go without Part D drug coverage and don’t have other creditable coverage.) They may also consider purchasing a Medicare supplemental insurance policy (Medigap) if the option is available to them (see question 4 for details about Medigap and potential limits on enrollment).

Medicare beneficiaries are encouraged to review their current source of Medicare coverage during the annual open enrollment period and compare other options that are available where they live. Because an individual’s medical needs can change over the course of the year, and from one year to the next, this may influence their priorities when choosing how they want to get their Medicare benefits. Medicare Advantage and Medicare prescription drug plans typically change from one year to the next and may vary in many ways that could have implications for a person’s access to providers and costs. Despite this, nearly 7 in 10 (69%) Medicare beneficiaries did not compare their Medicare coverage options during a recent open enrollment period.

3. Are There Other Opportunities for Medicare Beneficiaries to Make Coverage Changes Outside of the Open Enrollment Period?

Medicare provides several different Special Enrollment Periods (SEPs) where Medicare beneficiaries can make certain changes to their coverage outside of the annual open enrollment period under certain circumstances. For example, beneficiaries who experience disruptions to existing coverage (such as a cross-county move or a loss of employer- or union-sponsored coverage) or loss of Medicaid eligibility may qualify for a SEP at any time of year.

As of 2025, people who are enrolled in both Medicare and Medicaid (i.e., dual-eligible individuals) or who qualify for the Medicare Part D Low-Income Subsidy program (also known as “Extra Help”), can make certain changes to their coverage once per month. Beneficiaries in these groups may use this monthly SEP to disenroll from a Medicare Advantage plan into traditional Medicare, enroll in a stand-alone Part D drug plan, or switch between Part D plans. However, they may not use the monthly SEP to enroll in Medicare Advantage or switch between Medicare Advantage plans, with the exception of individuals with full Medicaid benefits who are switching to a Fully Integrated Dually Eligible Special Needs Plan (FIDE SNP), a Highly Integrated Dually Eligible Special Needs Plan (HIDE SNP), or a coordination-only D-SNP that is an Applicable Integrated Plan (AIP) that is aligned with their Medicaid managed care enrollment.  People living in nursing homes and certain other facilities may change their Medicare Advantage or Medicare Part D coverage once per month.

Medicare Advantage enrollees who wish to change plans or switch to traditional Medicare may do so between January 1 through March 31 each year, during the Medicare Advantage Open Enrollment Period. (This is in addition to the open enrollment period that runs from October 15 to December 7.) Additionally, those who have a Medicare Advantage or Medicare Part D plan with a 5-star quality rating available in their area may switch into a 5-star plan between December 8 and November 30 of the following year.

For 2026, people who select a Medicare Advantage plan based on inaccurate provider directory information in Medicare Plan Finder may qualify for a new, temporary SEP that allows them to switch to a different Medicare Advantage plan or return to traditional Medicare if they later discover that their preferred provider is not included in their plan’s network. This temporary SEP is currently limited to coverage decisions made for the 2026 plan year and runs for three months after the effective date of plan election. This is distinct from an existing SEP that allows Medicare Advantage enrollees to make changes to their coverage if their plan makes certain changes to its provider network that are deemed “significant,” such as terminating a large number of in-network providers. (See Q6 for more information about Medicare Advantage provider networks.)

The annual open enrollment period and other opportunities to switch coverage are distinct from the initial enrollment period for people who are newly enrolling in Medicare, which begins three months before a person’s 65^th birthday and ends three months after it. For more information on initial enrollment, see KFF’s Medicare Open Enrollment FAQ.

4. How Does Supplemental Coverage, like Medigap and Employer-Sponsored Retiree Health Benefits, Factor into Medicare Coverage Decisions?

Many Medicare beneficiaries have some form of additional coverage, such as a Medicare Supplemental Insurance policy (Medigap) or coverage offered by an employer or a union, that helps with Medicare’s cost-sharing requirements. Enrollment in these plans and programs is not tied to the open enrollment period, though beneficiaries may wish to take them into account when considering their options for Medicare coverage.

Medigap. People in traditional Medicare with both Part A and Part B can apply for a Medigap policy at any time of the year. Medigap policies are designed to help beneficiaries in traditional Medicare with Medicare’s deductibles and cost-sharing requirements and have standard benefits to allow for apples-to-apples comparisons across insurers. Traditional Medicare beneficiaries with a Medigap plan that covers most deductible and cost-sharing requirements may have lower out-of-pocket spending for Medicare-covered services than people with other coverage, including a Medicare Advantage plan. Medigap policies are designed to wrap around traditional Medicare, and do not work with Medicare Advantage. People enrolled in Medicare Advantage do not need (and can’t buy) a Medigap policy.

While Medigap insurers are required to issue policies to people age 65 or over, without regard to health status or diagnosed medical conditions when they first enroll in Medicare, those with pre-existing conditions may be denied a Medigap policy or face higher premiums in most states if they apply for Medigap coverage after their first six months of enrollment in Part B. People who disenroll from Medicare Advantage within 12 months of first enrolling in Medicare Advantage have a right to purchase a Medigap policy without regard to medical history, but after 12 months, they are not guaranteed Medigap coverage and may be denied a policy due to a pre-existing condition or face higher Medigap premiums if they are offered a policy.

Medigap guaranteed issue rights are different for people under age 65 who qualify for Medicare due to long-term disability. Federal law does not require Medigap insurers to sell a policy to people with Medicare under age 65, although several states do require insurers to offer at least one kind of Medigap policy to people under 65. Premiums for Medigap policies sold to people under age 65 are typically higher than policies sold to those age 65 or older. People under age 65 with disabilities who are already enrolled in Medicare will qualify for the 6-month Medigap open enrollment period when they turn 65 and become age eligible for Medicare. At this point, they can buy any Medigap policy they want without facing higher premiums or denials of coverage based on their existing medical conditions.

Employer-sponsored coverage. While employer-sponsored retiree health benefits are on the decline, more than 14.5 million people with Medicare have retiree health coverage (distinct from people with Medicare Part A only who continue to work and have health insurance through their current employer or a spouse’s current employer). Retiree health benefits may be designed to supplement either traditional Medicare or Medicare Advantage. Some employers that offer health benefits to retirees on Medicare offer these benefits exclusively through a Medicare Advantage plan. Beneficiaries with retiree health coverage offered exclusively through a Medicare Advantage plan may lose these benefits if they choose to switch to traditional Medicare during the annual open enrollment period. Similarly, employers may only offer a retiree health benefit that supplements traditional Medicare. If a person with such coverage switches from traditional Medicare to Medicare Advantage during an open enrollment period, they may lose their retiree health benefits. In fact, if a Medicare beneficiary drops their employer or union-sponsored retiree health benefits for any reason, they may not be able to get them back.

5. How Does Additional Support for Low-Income People Factor into Medicare Coverage Decisions?

Low-income Medicare beneficiaries who meet their states’ Medicaid eligibility criteria qualify for additional coverage of services through Medicaid that are not covered under Medicare, such as long-term services and supports. Additionally, Medicare beneficiaries with modest incomes may qualify for assistance with Medicare premiums and out-of-pocket costs from the Medicare Savings Programs (MSP) and Part D Low-Income Subsidy (LIS) if their income and assets are below certain amounts. Medicare beneficiaries who are eligible for Medicaid, the Medicare Savings Programs (MSPs), or Medicare Part D Low-Income Subsidies (LIS), but not yet enrolled in these programs, can enroll at any time of the year. This additional coverage and assistance may factor into how people choose to receive their Medicare benefits. 

Medicaid. For people with Medicare who qualify for full Medicaid benefits, their choice of Medicare coverage can impact how they receive Medicaid benefits and the degree to which those benefits are coordinated with Medicare. In general, Medicaid wraps around Medicare coverage, with Medicare as the primary payer and Medicaid paying for costs and services not covered by Medicare. People who are eligible for both Medicare and Medicaid (dual-eligible individuals) can enroll in a Medicare Advantage plan designed for this population, such as a dual-eligible Special Needs Plan (SNP), and depending on the state and the plan, may experience a higher level of coordination of their benefits. Beginning in 2025, people who qualify for full Medicaid benefits can make certain changes to their Medicare coverage outside of the open enrollment period, up to once per month (see Q3 for further details).

Medicare Savings Programs. Through the Medicare Savings Programs (MSP), state Medicaid programs pay Medicare premiums and, in many cases, cost sharing for Medicare beneficiaries who have income and assets below certain amounts (though some states have lifted their income and/or asset thresholds above the federal limits). Specifically, states cover the Medicare Part B premium for people who qualify and may also provide assistance with Medicare deductibles and other cost-sharing requirements. People who receive MSP assistance and are enrolled in a Medicare Advantage plan may still have cost sharing associated with non-Medicare covered services offered by the plan. People who qualify for MSP but not full Medicaid benefits (sometimes referred to as “partial Medicaid benefits”) can also make certain changes to their coverage outside of the open enrollment period, up to once per month. 

Part D Low-Income Subsidy. People who qualify for the Part D Low-Income Subsidy (LIS) receive varying levels of assistance toward their Part D prescription drug coverage premiums and cost sharing, depending on their income and asset levels. Dual-eligible individuals, people enrolled in the Medicare Savings Programs, and those who receive Supplemental Security Income payments from Social Security automatically qualify for LIS benefits, and Medicare automatically enrolls them into a stand-alone Part D drug plan in their area with a premium at or below a certain amount (the Low-Income Subsidy benchmark) if they do not choose a plan on their own. Other beneficiaries are subject to both an income and asset test and need to apply for the LIS through either the Social Security Administration or Medicaid. People who receive LIS assistance can select any Part D plan offered in their area, but if they enroll in a plan that is not a so-called “benchmark plan” (that is, plans available without a premium to enrollees receiving full LIS), or their current plan loses benchmark status, they may be required to pay some portion of their plan’s monthly premium, which would diminish the value of the premium subsidy. People who receive LIS can also make certain changes to their coverage outside of the open enrollment period, up to once per month.

6. How Do the Features of Traditional Medicare Compare to Those of Medicare Advantage?

Traditional Medicare and Medicare Advantage both provide coverage of all services included in Medicare Part A and Part B, but certain features, such as out-of-pocket costs, provider networks, and access to extra benefits vary between these two types of Medicare coverage. When deciding between traditional Medicare and Medicare Advantage, Medicare beneficiaries may want to consider a variety of factors, such as their own health and financial circumstances, preferences for how they get their medical care, which providers they see, and their prescription drug needs. These decisions may involve careful consideration of premiums, deductibles, cost sharing and out-of-pocket spending; extra benefits offered by Medicare Advantage plans; how the choice of coverage option may affect access to certain physicians, specialists, hospitals and pharmacies; rules related to prior authorization and referral requirements; and variations in coverage and costs for prescription drugs.

People may prefer traditional Medicare if they want the broadest possible access to doctors, hospitals and other health care providers. Traditional Medicare beneficiaries may see any provider that accepts Medicare and, if they are new to the provider, accepts new patients. People with traditional Medicare are not required to obtain a referral for specialists or mental health providers. Additionally, prior authorization is rarely required in traditional Medicare and only applies to a limited set of services. With traditional Medicare, people have the ability to choose among stand-alone prescription drug plans offered in their area, which tend to vary widely in terms of which drugs are covered and at what cost. (Beginning in 2026, a pilot initiative known as the Wasteful and Inappropriate Services Reduction (WISeR) model will test the use of prior authorization in traditional Medicare for a small set of outpatient services in six states. The WISeR model is limited to traditional Medicare, though most Medicare Advantage plans already require prior authorization for some services.)

People may prefer Medicare Advantage if they want extra benefits, such as coverage of some dental and vision services, and reduced cost sharing offered by these plans, often for no additional premium (other than the Part B premium). Additionally, Medicare Advantage plans are required to include a cap on out-of-pocket spending, providing some protection from catastrophic medical expenses. Medicare Advantage plans also offer the benefit of one-stop shopping (i.e., people who enroll have coverage under one plan and do not need to sign up for a separate Part D prescription drug plan or a Medigap policy to supplement traditional Medicare).

7. How do Medicare Advantage Plans Vary?

The average Medicare beneficiary can choose from 39 Medicare Advantage plans in 2026, including 32 Medicare Advantage plans with Part D coverage, though the average number of plan options varies widely across states (Figure 2). These plans vary across many dimensions, including premiums and out-of-pocket spending, provider networks, extra benefits, prior authorization and referral requirements, and prescription drug coverage. As a result, enrollees face different out-of-pocket costs, access to providers and pharmacies, and coverage of non-Medicare benefits (such as dental, vision and hearing) based on the Medicare Advantage plan they choose.

Premiums and out-of-pocket spending. Medicare Advantage enrollees may be charged a separate monthly premium (in addition to the Part B premium). In 2025, the average enrollment-weighted premium for Medicare Advantage plans was $13 per month, though three quarters (76%) of enrollees were in plans that charged no additional premium (apart from the Part B premium).

Medicare Advantage plans are generally prohibited from charging more than traditional Medicare, but vary in the deductibles, co-pays and co-insurance they require. For example, plans typically charge a daily co-pay for hospital stays, which vary both in the amount and the number of days for which they apply.

Medicare Advantage plans are required to include a cap on out-of-pocket expenses. In 2025, this cap may not exceed $9,350 for in-network services or $14,000 for all covered services. Most plans have an out-of-pocket limit below this cap, averaging $5,320 for in-network services and $9,547 for in-network and out-of-network services combined. Out-of-pocket limits only apply to services covered under Medicare Parts A and B.

Provider networks. Medicare Advantage plans are permitted to limit their provider networks, the size of which can vary considerably for both physicians and hospitals, depending on the plan and the county where it is offered. Medicare Advantage plans that include prescription drug coverage may also establish pharmacy networks or designate preferred pharmacies, where enrollees will have lower out-of-pocket costs. If a Medicare Advantage plan provides coverage of out-of-network providers, it may require higher cost sharing from enrollees for these services. For the 2026 plan year, the Medicare Plan Finder tool will incorporate searchable provider directories for Medicare Advantage plans. While these directories will initially include plan network information sourced from a third-party vendor, insurers will be required to provide regular updates to this information from January 2026 onward, including notifications within 30 days of any changes to a plan’s network and annual attestations that the listed directories are up to date.

Extra benefits. Medicare Advantage plans may choose to offer extra benefits not covered by traditional Medicare, such as some coverage of dental, vision, and hearing services. Virtually all Medicare Advantage enrollees are in a plan that offers extra benefits, including some coverage of eye exams and/or eyeglasses (more than 99%), dental care (98%), hearing exams and/or aids (95%), and a fitness benefit (94%). Additionally, a majority of Medicare Advantage enrollees are in plans that provide an allowance for over-the-counter items (79%) and meals following a hospital stay (70%). While extra benefits are common, the scope of coverage varies widely from plan to plan. For example, in 2021, more than half (59%) of Medicare Advantage enrollees were in a plan with a maximum dental benefit of $1,000 or less, while nearly one-third (30%) were in a plan with a limit between $2,000 and $5,000.

Prior authorization and referral requirements. Medicare Advantage plans may require enrollees to receive prior authorization before a service will be covered. In 2023, nearly 50 million prior authorization requests were submitted to insurers on behalf of Medicare Advantage enrollees, and in 2025, virtually all Medicare Advantage enrollees are in plans that require prior authorization for some services, such as inpatient hospital stays, diagnostic tests and procedures, or stays in a skilled nursing facility. Prior authorization may also be required for some services included in a plan’s extra benefits, such as hearing and eye exams or comprehensive dental services. In addition, Medicare Advantage plans may require enrollees to obtain a referral from a primary care provider in order to see a specialist or mental health provider.

Beginning in 2026, Medicare Advantage plans will be required to follow additional requirements when making prior authorization decisions. These include issuing decisions within a set timeframe (7 calendar days for standard requests or 72 hours for expedited requests), informing beneficiaries and providers of the specific reason a request is denied, and reporting certain information about their prior authorization processes on their public websites by March 31 each year, such as the share of requests that were approved, denied, or approved after appeal in the prior calendar year.

Prescription drug coverage. Medicare Advantage enrollees who want prescription drug coverage must choose a plan that offers this coverage, as they are not permitted to enroll in a stand-alone prescription drug plan while enrolled in Medicare Advantage. Medicare Advantage plans that include prescription drug coverage may also charge a drug deductible. Drug coverage in Medicare Advantage plans varies along the same dimensions as drug coverage in stand-alone Part D plans (described below).

8. How Do Part D Plans Vary?

Medicare beneficiaries have between 8 and 12 stand-alone Part D plans to choose from for 2026 (Figure 3) (in addition to a large number of Medicare Advantage drug plans, if they want to consider Medicare Advantage for all of their Medicare-covered benefits). For traditional Medicare beneficiaries who want to add Part D coverage, stand-alone Part D plans vary in terms of premiums, deductibles and cost sharing, the drugs that are covered and any utilization management restrictions that apply, and pharmacy networks. These differences can affect enrollees’ access to prescription drugs and out-of-pocket costs.

Premiums. People in traditional Medicare who are enrolled in a separate stand-alone Part D plan generally pay a monthly Part D premium unless they qualify for benefits through the Part D Low-Income Subsidy (LIS) program and are enrolled in a premium-free (benchmark) plan. In 2025, the average enrollment-weighted premium for stand-alone Part D plans was $39 per month. Changes to the Part D benefit in the Inflation Reduction Act, such as the cap on out-of-pocket drug spending for Part D enrollees ($2,100 in 2026), mean lower out-of-pocket costs for many Medicare beneficiaries but higher costs for Part D plan sponsors (see Q9 for further discussion of the Inflation Reduction Act).

Deductibles and cost sharing. Deductibles and cost-sharing requirements for prescription drug coverage vary across plans. In 2026, the standard deductible for Part D coverage is $615, but some plans charge a lower or no deductible. Plans generally impose a tier structure to define the cost-sharing amounts charged for different types of drugs. Plans typically charge lower cost-sharing amounts for generic drugs and preferred brands and higher amounts for non-preferred and specialty drugs, and charge a mix of flat dollar copayments and coinsurance (based on a percentage of a drug’s list price) for covered drugs. Separate cost-sharing rules now apply to insulin, where copays are capped at $35 per month, and adult vaccines covered under Part D, where no cost sharing can be charged, based on provisions in the Inflation Reduction Act of 2022.

Drugs covered and utilization management restrictions. Part D plans include a list of drugs they cover (also referred to as a plan’s formulary). In addition, plans impose utilization management restrictions on some covered prescription drugs, including prior authorization, quantity limits, and step therapy, which can affect beneficiaries’ access to medications. In 2025, Part D plans applied utilization management requirements to around half of all drugs covered on a plan’s formulary.

Pharmacy networks. Part D prescription drug plans may establish pharmacy networks or designate preferred pharmacies, where enrollees will have lower out-of-pocket costs.

9. What Changes Have Been Made to Medicare Eligibility Based on Immigration Status?

Prior to the tax and budget reconciliation law enacted in 2025, residents of the U.S. ages 65 or older, including citizens, permanent residents, and lawfully-present immigrants, were eligible for premium-free Medicare Part A if they had worked at least 40 quarters (10 years) in jobs where they or their spouses paid Medicare payroll taxes. Lawfully-present immigrants ages 65 or older without this work history could purchase Medicare Part A after residing legally in the U.S. for five continuous years. Lawfully-present immigrants under age 65 with long-term disabilities could also qualify for Medicare, provided they met the same eligibility requirements for Social Security Disability Insurance (SSDI) that apply to citizens. These requirements are based on work history, payment of Social Security taxes on income, and having enough years of Social Security taxes accumulated to equal between 20 and 40 work credits (5-10 years).

Starting in July 2025, Medicare eligibility is limited to U.S. citizens, permanent residents (i.e., green card holders), Cuban-Haitian entrants, and people residing under the Compacts of Free Association. Lawfully-present immigrants who don’t meet these criteria, such as refugees, asylees, and people with Temporary Protected Status, will no longer eligible for Medicare regardless of age or work history. Individuals with current Medicare coverage who do not fall in any of these categories will have their coverage terminated no later than January 2027.

10. What Resources are Available to Assist Medicare Beneficiaries in Understanding Their Coverage Options?

People with Medicare can learn more about Medicare coverage options and the features of different plan options by reviewing the Medicare & You handbook. In addition, people can review and compare the Medicare options available in their area by using the Medicare Plan Compare website, a searchable tool on the Medicare.gov website, by calling 1-800-MEDICARE (1-800-633-4227), or by contacting their local State Health Insurance Assistance Program (SHIP). SHIPs offer local, personalized counseling and assistance to people with Medicare and their families. Contact information for state SHIPs can be found by calling 877-839-2675 or by checking the listing provided on the Medicare.gov website.

Additionally, many people use insurance agents and brokers to navigate their coverage options. While independent agents and brokers can be helpful, they are typically financially compensated by private insurers for enrolling people in their plans, and often receive higher commissions if people choose a Medicare Advantage plan rather than remaining in traditional Medicare and purchasing a supplemental Medigap policy and stand-alone Part D plan.

Short-term, limited-duration (STLD) health plans have long been sold to individuals through the “non-group” (individually-purchased) private insurance market and through industry associations. STLDs were designed for individuals who experience a temporary gap in health coverage, such as someone who is between jobs. Short-term plans are often marketed as less expensive alternatives to health insurance sold on the Affordable Care Act (ACA) Marketplace. However, STLDs provide less comprehensive coverage and have fewer consumer protections than Marketplace plans. As Open Enrollment for Marketplace plans nears, recent actions taken by Congress and the Trump administration, and the potential expiration of enhanced premium tax credits, are likely to result in millions of people losing coverage or having to pay substantially higher premiums for Marketplace coverage. At the same time, the Trump administration recently announced that it would not prioritize enforcement actions for violations of Biden-era consumer protections for short-term plans, and that it intends to undertake rulemaking, which could roll back those regulations. Taken together, these changes could lead more consumers to purchase less expensive and less comprehensive coverage, such as short-term plans, instead of a more comprehensive ACA plan this Open Enrollment season.

KFF has analyzed short-term health policies sold on the websites of nine large insurers in a major city in each of the 36 states where short-term plans are available. These insurers offer 30 distinct products, with a total of approximately 200 distinct plans. For more details, see the Methods section. This brief provides an update to and expansion of a similar 2018 KFF quantitative analysis, examining premiums, cost sharing, covered benefits, and coverage limitations of these short-term policies, and comparing their features to plans sold on the ACA Marketplace.

Key Takeaways

• Short-term plans are sold in 36 states. Five states prohibit the sale of short-term health plans, and in nine states plus the District of Columbia, short-term plans are not outright prohibited, but none are available due to more extensive state regulations.
• Premiums for the lowest-cost short-term plans can cost two-thirds or less than the lowest-cost unsubsidized Bronze plans sold on the ACA Marketplace in the same area. However, the vast majority of Marketplace enrollees receive premium tax credits, which can effectively result in similarly priced or even cheaper Marketplace plans, all of which provide more comprehensive coverage than the highest cost short-term plan.
• Short-term plans tend to have lower premiums because they are medically underwritten and have pre-existing condition exclusions. For example, an individual with cancer, obesity, or who is pregnant is likely to be declined. Additionally, the lowest-cost short-term plan premium for a 40-year-old woman ranges from 6% to 19% higher than the lowest-cost premium for a man. These practices are not permitted in ACA-compliant plans.
• Short-term plan deductibles for an individual in select U.S. cities range from $500 to $25,000 compared to $0 to $9,200 for Bronze Marketplace plans. Silver and Gold plans have lower deductibles, but also higher premiums. Unlike all ACA-compliant plans, most short-term plans do not have out-of-pocket (OOP) maximums or only apply these maximums to certain OOP expenses. The maximum benefit limits for short-term plans sold in these ten cities are as low as $100,000 per policy term. ACA-compliant plans are not allowed to have annual or lifetime dollar limits.
• Among all the short-term products we reviewed, 40% do not cover mental health services, 40% do not cover substance abuse treatment, 48% do not cover outpatient prescription drugs, and almost all exclude coverage for adult immunizations (94%) and maternity care (98%). All ACA-compliant plans must cover these services.
• Even when short-term plans do cover these and other benefits, limitations and exclusions almost always apply that would not be permitted under ACA-compliant plans, such as separate benefit limits, limits on the number of primary care visits the plan will cover, and limits on the number of days the plan will cover inpatient hospital care.

Background

Consumer Protections

As the name suggests, short-term health plans are not required to be renewable. Whereas federal law, since 1996, has required all other individual health insurance to be guaranteed renewable at the policyholder’s option, coverage under a short-term policy terminates at the end of the contract term. Continuing coverage beyond that term requires applying for a new policy. An individual who buys a short-term policy and then becomes seriously ill will not be able to renew coverage when the policy ends.

The ACA prohibits health insurance plans sold on the non-group market from practices such as medical underwriting, pre-existing condition exclusions, and lifetime and annual limits. ACA-compliant plans are required to provide minimum coverage standards and limit out-of-pocket cost sharing ($9,200 for an individual in 2025). Since short-term plans are not regulated as individual market insurance under federal law, these market rules do not apply to short-term plans, which, by contrast, can:

• base premiums, without limit, on health status, gender, and age;
• require application fees or enrollment in a special association to be eligible for coverage;
• deny coverage for people with pre-existing conditions, or exclude coverage for those conditions;
• exclude coverage for essential health benefits, including maternity care, prescription drugs, mental health care, and preventive care, and limit coverage in other ways;
• impose lifetime and annual dollar limits on covered services;
• not have an out-of-pocket maximum on patient cost sharing; and
• exclude other ACA consumer protections, such as rate review or minimum medical loss ratios.

Short-term policies are not considered “minimum essential coverage,” the term used to describe health coverage that meets the ACA requirement that individuals have health coverage, and which determines eligibility for Special Enrollment Periods. Therefore, loss of short-term coverage does not qualify an individual for a Special Enrollment Period in the ACA Marketplace, so they would have to wait until the next Open Enrollment period to enroll in an ACA Marketplace plan.

There is no current or comprehensive data on the number of consumers enrolled in an STLD. Most available estimates are a substantial undercount because they do not account for STLDs sold through associations, which is likely the majority. The most comprehensive estimate may come from a 2020 Congressional investigation, which estimated that approximately 3 million people were enrolled in a short-term plan at some point during 2019.

Federal Laws and Regulations

Today, short-term plans are typically available for one to six months, with some issuers offering coverage for up to 12 months and one offering “three-packs” of short-term policies, enabling consumers to buy up to three years of short-term coverage at a time. The duration and renewability of STLD plans have been the subject of changing federal regulations, as shown in Table 1.

To address reports of misleading marketing and deceptive sales tactics, current federal regulations also require short-term plans to conspicuously notify consumers that short-term plans are “NOT comprehensive coverage” and to include standardized language describing STLD plans’ coverage limitations in comparison to insurance sold on HealthCare.gov.

The Trump administration’s 2018 regulation expanding the permitted duration of short-term plans was challenged in district court, with a 2019 ruling in favor of the government. The Biden administration once again imposed limits on the use of short-term plans. In August 2025, the Trump administration announced that it would no longer prioritize enforcement of Biden-era regulations on short-term plans and that it intends to undertake corresponding rulemaking. Amendments to these provisions could, again, prompt lawsuits. Meanwhile, a lawsuit challenging the 2024 regulations is working its way through the courts.

State Laws and Regulations

Short-term health plans are available in 36 states (Figure 1). Five states (CA, IL, MA, NJ, and NY) have laws prohibiting the sale of short-term health plans. In nine states plus the District of Columbia, short-term plans are not prohibited, but none are available due to more extensive state regulations that require these plans to provide more consumer protections than they do in other states (e.g., no pre-existing condition exclusions, coverage of certain benefits, shorter durations).

How Short-Term Plans Compare to Bronze-Level ACA Marketplace Plans

Premiums

Due to coverage limitations and fewer consumer protections, short-term policies, unsurprisingly, typically have lower premiums than unsubsidized Bronze plans, a trend that is similar to our 2018 analysis. (Note, however, that the methodology used for this analysis differs from that used in 2018, and some of the states we reported data for in 2018 no longer have short-term plans for sale.) Our cost analysis of approximately 200 short-term plans sold by nine major insurers in the 36 states where short-term plans are available found that many of the cheapest short-term plans for a 40-year-old non-smoker were priced at two-thirds or less of the premium for the lowest-cost ACA-compliant, unsubsidized Bronze plan in the same area (Table 2). However, premiums for the highest-price short-term plans, which typically have lower cost sharing, are higher than the highest-cost Bronze plan in four of the ten cities shown in the table for males and five of the cities for females. All Bronze plans provide more comprehensive coverage than even the highest-cost short-term plans.

The vast majority (93%) of ACA Marketplace enrollees receive a premium tax credit tied to their income, reducing both the price they pay for a Marketplace plan and the price difference between the lowest cost short-term plan and the lowest cost Bronze plan. In some cases, the lowest-cost subsidized Bronze plan is cheaper than the lowest-cost short-term plan sold in the area. For example, the cheapest Bronze plan for a 40-year-old individual living in Houston, TX, who earns $45,140 per year (the median individual income in the U.S. in 2024) and receives a premium tax credit, would be 5% less for a male and 23% less for a female than the cost for the lowest-cost short-term plan. Additionally, in nine of the ten cities in Table 2, the highest-cost subsidized Bronze plan for an individual earning $45,140 per year is lower than the highest-cost short-term plan, sometimes by hundreds of dollars. Premiums for Silver plans, with the tax credit, would be higher, but also come with lower deductibles.

ACA-compliant plans are not permitted to charge women higher premiums than men. There are no equivalent federal requirements for short-term plans, and as such, short-term plans can and do charge women more than men. Among the ten major cities shown, the lowest-cost short-term plan premium for a 40-year-old woman ranges 6% to 19% higher than the lowest-cost premium for a man. ACA-compliant plans may charge higher premiums for older consumers than younger consumers, but only within specified limits. These limits do not apply to short-term plans. For example, in Phoenix, AZ, the lowest-cost Bronze plan for a 60-year-old individual is 112% higher than for a 40-year-old, whereas the lowest-cost short-term plan costs 311% more for a 60-year-old male and 228% more for a 60-year-old female.

In addition to monthly premiums, most short-term products require one-time application fees, which typically range in price from $20 to $35. Additionally, all the national insurers require enrollment in a special association to be eligible for coverage in most states (e.g., one association serves as a source of information on consumer issues and offers its members products and services in a variety of areas); three of these insurers require enrollees to pay an extra monthly fee for the association membership, ranging from $15 to $25 per month. Taken together, these fees can turn a three-month short-term policy with a $70 monthly premium into a policy that actually costs over $100/month. Plans sold on the ACA Marketplace do not charge application fees or require association memberships.

Cost Sharing

In addition to premiums, cost sharing is another consideration when comparing the affordability of short-term plans to ACA-compliant plans. An insurer may offer several plans with variable cost-sharing structures within each product type. Cost sharing does not typically vary by the enrollee’s age or sex. A deductible is the amount an enrollee has to pay out-of-pocket in the plan year (or policy term) before insurance will begin paying for most covered services. In general, health insurance plans that have lower premiums tend to have higher deductibles and vice versa.

Among the ten major cities analyzed for this part of the analysis, deductibles for Bronze Marketplace plans range from $0 (an HMO in Milwaukee, WI) to $9,200 (most cities); in 2025, no ACA-compliant plans can have a deductible exceeding this amount (Table 3). In comparison, deductibles for short-term plans in these cities range from $500 (Houston, TX) to $25,000 (all cities), nearly three times higher than the highest deductible for a Bronze plan. Some consumers enrolled in a short-term plan with a shorter duration (such as three or four months) and a higher deductible may never meet the deductible during the policy term and may end up paying for care entirely out-of-pocket.

In the individual market, plans must have an out-of-pocket (OOP) maximum on enrollee cost sharing (including deductibles, coinsurance, and copayments) for covered services provided by an in-network provider. For the 2025 plan year, the OOP max cannot be higher than $9,200 for single coverage. If an enrollee meets the OOP maximum, the plan must pay for covered services in full (meaning no enrollee cost sharing) for the remainder of the plan year. Short-term plans, on the other hand, are not required to have an OOP maximum under federal law, and many do not, meaning there is no limit to the amount an enrollee must pay out of pocket for covered services during the policy term. When a short-term plan does have an OOP maximum, sometimes the deductible and coinsurance count toward the OOP max (not copayments, cost sharing for services with a benefit limit that has been exceeded, or facility fees). In the major cities shown, OOP maximums for a Bronze Marketplace plan range from $7,100 (Portland, OR) to $9,200 (all cities). While the lowest OOP max for a short-term plan in these cities is $2,000 (most cities), short-term plans that have no OOP maximum are available in all but one city (Portland, OR). Among short-term plans that do have an OOP maximum, OOP maximums are as high as $32,500 in most cities, approximately three and a half times higher than the highest OOP maximum for a Bronze plan.

All short-term plans have a total dollar limit that they will pay for covered care during the term of the plan, or sometimes over the enrollee’s lifetime. The maximum benefit limits among the ten are as low as $100,000 per policy term. This means that if the plan spends $100,000 on covered services for an enrollee, the plan will not pay for any more covered services the enrollee receives during the policy term. This amount is lower than in 2018, when the lowest coverage limit was $250,000. ACA-compliant plans are prohibited from imposing dollar limits on how much they will pay for covered services during the plan year (unless those services are not part of the ACA’s essential health benefits).

Covered Benefits

All plans sold on the ACA-Marketplace must cover these 10 essential health benefits: hospitalization, ambulatory services, emergency services, maternity and newborn care, mental health and substance abuse treatment, prescription drugs, laboratory services, pediatric services, rehabilitative and habilitative services and devices, and preventive care (many of these preventive services must also be covered without cost sharing). In contrast, there are no federal requirements for short-term plans to cover the essential health benefits, though many short-term plans provide at least some level of coverage for some of these benefits, and some states have their own coverage requirements for certain services.

This part of the analysis examines specific benefits covered by 30 distinct short-term products from nine major insurers in the 36 states where short-term plans are available. This information is based on shopping tools and plan documents available on the insurers’ websites, including state variations when provided. Table 4 shows the percentage of short-term products by major city that cover at least some services in five benefit categories: mental health services, substance use services, prescription drugs, adult immunizations, and maternity services. Note that short-term plans that cover these benefit categories often apply limits and exclusions on these services, which are not reflected in this table, but are discussed in more detail below.

Of the short-term products reviewed, just 60% cover mental health services, 60% cover services for substance abuse treatment, 52% cover prescription drugs, 6% cover adult immunizations, and just 2% cover maternity care. In two states (AK and MD), mental health services are not covered by any short-term product, and in six other states, fewer than half cover them. There are no short-term products in Maryland that cover substance use treatment, and in six other states, fewer than half cover treatment. Two states (MD and SD) do not have any short-term products that cover prescription drugs, and in three other states, fewer than half cover them. Ten states have no short-term products that cover adult immunizations. Only two states (MT and NH) have products that cover maternity services. See the Methods section for how we defined a product as covering these benefits.

Benefit Limitations

Even when short-term plans do cover these benefits, limitations and exclusions almost always apply that would not be permitted under ACA plans. For example, thirteen of the fourteen products that cover prescription drugs apply a maximum dollar limit on the benefit, all ranging from $1,000 to $5,000 per policy term, except for one product with a $10,000 pharmacy benefit limit. Some short-term plans that cover prescription drugs also limit the types of drugs they will cover. For example, they may not cover contraceptives or may only cover them if the primary purpose they are being prescribed for is not to prevent pregnancy. Additionally, many products that cover prescription drugs do not cover specialty drugs, and some only cover “maintenance” medications for certain chronic conditions. Short-term products that cover mental health and substance abuse treatment impose significant limits on the benefits. Examples of coverage limitations for these benefit categories include a $50 maximum benefit for outpatient visits, a 31-day maximum for inpatient care, and a benefit limit of $3,000 per policy term. Additionally, short-term products that cover treatment for substance use disorders usually do not cover illnesses or injuries resulting from being under the influence of alcohol, illegal substances, or controlled substances unless they were prescribed to that individual.

Short-term products have several other limitations on covered benefits. For example, while nearly all advertise coverage for preventive care, most services require cost sharing or dollar limits that would not be permitted in ACA-compliant plans. Other common examples of per policy term limitations and additional costs include coverage of only one office, coverage of no more than three emergency room visits, an additional $750 deductible for inpatient care, and a $15,000 benefit limit for all covered outpatient care.

All of the short-term products reviewed exclude coverage for pre-existing health conditions, and most have waiting periods for at least some services, rendering coverage of certain covered benefits less meaningful than they may seem at first glance. For example, nearly eight in ten products advertise coverage for cancer treatment, but anyone who has been diagnosed with cancer before enrolling would be denied coverage when they apply. Even if there had been no cancer diagnosis before enrolling in the plan, if the enrollee is first diagnosed with cancer while enrolled in the short-term plan, the plan could deny coverage for treatment if the symptoms should have caused an “ordinarily prudent person” to seek medical care, or the plan could terminate coverage altogether. Additionally, for many cancers, a course of treatment would take much longer than short-term coverage would last. By contrast, ACA-compliant health plans are prohibited from having pre-existing condition exclusions or dropping coverage if the enrollee gets sick. Other common health conditions that are typically considered “declinable” by short-term plans include having a history of ulcers or Crohn’s disease, diabetes, depression, heart disease, and obesity; recent pregnancy is also considered a pre-existing health condition by short-term plans.

Looking Forward

With the ACA enhanced premium tax credits slated to expire at the end of this year and new federal policies on the horizon that are expected to result in millions of people losing coverage, more individuals may consider purchasing less expensive and less comprehensive coverage, such as short-term health plans. Without federal enforcement of Biden-era consumer protections, short-term health plans already are available for longer durations, and while all short-term products we reviewed do include the consumer warning currently required, insurers could opt to exclude or modify it in future plan years. Consumers, who, as mentioned above, have been the target of aggressive and, at times, misleading marketing of short-term plans, could end up enrolled in plans that cover less than they thought and leave them on the hook for higher out-of-pocket costs than are permitted under Marketplace plans. Relatedly, the Trump administration has already taken action to expand access to catastrophic plans sold on the Marketplace, beginning with the coming Open Enrollment period. Although these plans must meet all the requirements of metal-level Marketplace plans (described above), they have much higher cost sharing.

Additionally, to the extent that healthy individuals opt for short-term plans instead of ACA-compliant plans, this adverse selection could contribute to instability in the non-group market and raise the cost of comprehensive coverage, particularly for those who are not eligible for premium tax credits. Furthermore, short-term plans are just one loosely regulated alternative to ACA plans. Other types of coverage that consumers could be steered to by marketers and insurers include fixed indemnity plans, cancer-only plans, hospital-only plans, and other types of supplemental coverage.

If the Trump administration issues regulations rolling back the 2024 regulations limiting the duration of short-term plans and requiring a standardized consumer warning on these products, which it aims to do by the end of 2026, additional lawsuits are likely. Unlike previous litigation, however, legal challenges to new regulations would not face the same standard of judicial review that upheld the 2018 Trump regulations.

Considering the significant attention focused on issues like high drug prices, the opioid epidemic, and mental health, it is notable that short-term plans often exclude or severely limit coverage for mental health, substance use, and prescription drugs. Because short-term plans provide less comprehensive coverage and fewer consumer protections than ACA-compliant plans, people who buy short-term policies in order to reduce their monthly premiums risk that if they do need medical care, they could be left with significant medical bills.

In the summer and fall of 2025, we analyzed publicly-available information published on the websites of nine insurers: Allstate, United, Pivot, Everest, Select Health, Moda Health, BCBS of ID, BCBS of SC, and Medical Mutual. We believe these insurers are the primary sellers of short-term plans in the U.S, representing a wide breadth of short-term plans and products in the 36 states where short-term plans are sold. The number of insurers in each state ranges from one in Alaska, Maryland, New Hampshire, and North Dakota, to five in Ohio, South Carolina, and Texas. We used the online shopping tool for each insurer to identify the plans available in one major city of each of the 36 states and reviewed both the information in the search results and accompanying plan documents. One issuer sells a short-term product in some states that is guaranteed issue. For an equivalent comparison across all other insurers and products, this analysis does not include that product.

Each short-term product has a unique name and set of benefits and often offers multiple plans with different cost-sharing structures. The insurers in this analysis offer 30 distinct products (representing a total of approximately 200 unique plans), ranging from one product in Maryland to 23 in Ohio. The same product is often sold in multiple states, occasionally with variations in benefits by state. While we made every effort to account for state-level variations in this analysis, we only present information made available in insurers’ published plan documents and online shopping tools, which may be incomplete or may not reflect every specific state requirement, as some insurers may not make full coverage details available until after the plan has been purchased.

Premiums presented are for a 40-year-old non-smoker. Since premiums vary by gender for short-term plans, they are presented for males and females. Since ACA-compliant plans cannot base premiums on gender, only one set of premiums is presented.

For the analysis of covered benefits, products that only cover treatment for “organic” mental health conditions are not considered to cover mental health for this analysis. Products that only cover treatment for alcohol disorders are not considered to cover substance use. Products that only cover prescription drugs when administered in an inpatient setting, or that only provide a prescription drug discount card, are not considered to cover prescription drugs. A few products do not specify whether adult immunizations are covered. In these instances, we do not consider them to be covered. All products cover complications of pregnancy. Only products that also cover pregnancy care and childbirth are considered to cover maternity care.

At the start of his second term, President Donald Trump established the Make America Healthy Again (MAHA) Commission, chaired by Health and Human Services Secretary Robert F. Kennedy Jr., to examine the rise in chronic childhood conditions and develop federal strategies to address them. Recent MAHA Commission reports have covered issues including diet and exercise, the dangers of social media and excessive screen time, the impact of highly-processed foods, and use of prescription medications and vaccines. Findings from the KFF/Washington Post Survey of Parents shed light on the issues that parents see as top concerns for their children’s wellbeing and the attitudes and behaviors of parents who identify with the MAHA movement.

Key Takeaways

• About four in ten (38%) parents identify as supporters of the MAHA movement, a coalition that includes between three in ten and four in ten parents across gender, age, race, and ethnicity. Alignment with the movement among parents is highly correlated with political identification, as about six in ten Republican parents (62%), rising to eight in ten MAGA Republican parents (81%), identify with the President’s health movement, compared to about one in six (17%) Democratic parents. One third of independent parents (34%) identify with the movement.
• Many MAHA-supporting parents echo vaccine skepticism that has been amplified by HHS Secretary Kennedy. Nearly six in ten (56%) MAHA parents say they trust Kennedy to provide reliable information about vaccines, more than twice the share of non-MAHA-supporting parents who say the same (23%). While few MAHA parents say they are “anti-vaccine” (9%), a majority say they are “in the middle” when it comes to vaccines (55%), and their attitudes reflect this mix of views and behaviors. Most MAHA parents say they have kept their children up to date with recommended vaccines (75%), but at least four in ten say the CDC recommends too many vaccines for children (42%) and they are not confident in U.S. health agencies to ensure vaccine safety and effectiveness (58%).
• There is broad agreement across parents on some of the biggest issues facing children’s health in the U.S. today, with large shares of both MAHA-supporting parents and non-MAHA parents saying the use of social media (78% and 74% respectively) and mental health challenges (68% and 69%) are either the biggest or a major threat to children’s health. Majorities of both groups also cite highly processed foods (78% and 62%) and obesity (69% and 61%) as major threats to children’s health, though the shares are somewhat larger for MAHA parents compared to non-MAHA parents. Attitudes diverge on some other issues, with larger shares of MAHA parents than non-MAHA parents citing over-prescribing of medications (61% vs. 43%), neurodevelopmental disorders (48% vs. 38%), and fluoride in water supplies (33% vs. 25%) as at least major threats to children’s health. Parents who do not support the MAHA movement are more likely than MAHA parents to cite gun violence (68% among non-MAHA parents vs. 50% among MAHA parents), pollution (56% vs. 48%), difficulty affording enough food (50% vs. 41%), and infectious diseases (45% vs. 36%) as the biggest or major threats to children’s health in the U.S. today.
• The MAHA Commission’s policy goals related to regulating food in the U.S. have broad support, though parents are split on the question of whether to deregulate the sale of raw milk. At least eight in ten parents support increasing government regulations on dyes and chemical additives in food (85%), on highly processed food (82%), and on added sugars in food (80%). While MAHA-supporting parents are more likely than non-MAHA parents to support each of these regulation proposals, at least three in four, regardless of MAHA support, support these policy goals. About half (47%) of parents support deregulating the sale of unpasteurized milk, including much larger shares of MAHA (63%) than non-MAHA (36%) supporting parents.

Who Are MAHA Parents?

About four in ten (38%) parents say they are supporters of the MAHA movement, with support strongly tied to political identification. About six in ten (62%) Republican parents identify with the movement, rising to eight in ten (81%) among Republicans who support the Make America Great Again (MAGA) movement. About one-third (34%) of independent parents and one in six (17%) Democratic parents support the MAHA movement.

Larger shares of parents without a college degree (41%) than with a college degree (33%) support the MAHA movement, a difference that persists even when controlling for partisanship, MAGA identity, and other demographics.

About four in ten White parents (43%) say they support the MAHA movement compared to about three in ten Hispanic parents (32%) and Black parents (30%). While much media attention has been paid to so-called MAHA moms, a group of social media influencers who amplify the MAHA movement’s stance on food additives, this poll finds similar shares of mothers and fathers say they support MAHA, as do similar shares of parents across age groups.

Trusted Information Sources for MAHA Parents

There are wide divisions when it comes to trust in some sources of vaccine information for MAHA and non-MAHA parents. Pediatricians continue to be the most trusted source of information about vaccines for parents, with about eight in ten (81%) MAHA-supporting parents and about nine in ten (88%) non-MAHA parents saying they trust their child’s pediatrician “a great deal” or “a fair amount.”

Aside from pediatricians, majorities of MAHA parents say they trust their friends and family (58%), HHS Secretary Kennedy (56%), and their local public health departments (56%) for vaccine information, making these the top sources of vaccine information for these parents after pediatricians. About half of MAHA parents report trusting the CDC (51%) or FDA (47%) for information on vaccines. One-third or fewer MAHA parents say they trust their child’s school or daycare (37%), pharmaceutical companies (22%), or health and wellness influencers (14%) “a great deal” or “a fair amount” when it comes to reliable information about vaccines.

Vaccine Views Among MAHA-Supporting Parents

In a section titled “The Overmedicalization of Our Kids,” the White House’s MAHA report released earlier this year states that while vaccines protect children from infectious diseases, there has not been enough research into the risks of vaccines. Vaccine skepticism is a core component of the MAHA platform.

As with parents overall, MAHA and non-MAHA parents overwhelmingly value long-standing childhood vaccines but are more divided when it comes to the COVID-19 and flu vaccines for children. About nine in ten MAHA and non-MAHA parents see the measles, mumps, and rubella (MMR) (86% and 93% respectively) and polio (85% and 91%) vaccines as important for children in their communities, including majorities who say each of these are “very important.”

MAHA parents, however, are much less likely to say the COVID-19 or flu vaccines are important for children in their communities. Parents who do not support the MAHA movement are nearly twice as likely as MAHA parents to say it is “very” or “somewhat” important for children in their community to be vaccinated for COVID-19 (52% vs. 28%) and 20 percentage points more likely to say it is important for children to be vaccinated for the flu (64% vs. 44%).

While most MAHA and non-MAHA parents report confidence in the safety of MMR and polio vaccines, MAHA parents are less likely to be “very” confident. These parents are even less confident in the safety of flu and COVID-19 vaccines for children. About three in four MAHA parents (78%) and nearly nine in ten non-MAHA-supporting parents (88%) are confident in the safety of MMR vaccines, though MAHA parents are less likely than non-MAHA parents to be “very confident” (44% vs. 60%). Similarly, about eight in ten (79%) MAHA parents and nine in ten (88%) non-MAHA parents are confident in the safety of polio vaccines, with fewer MAHA parents being “very confident” (43% vs. 60%).

When it comes to the safety of COVID-19 vaccines for children, just one in four MAHA-supporting parents are “very” (9%) or “somewhat” (16%) confident, compared to about half (54%) of non-MAHA parents. In fact, about half (53%) of MAHA parents say they are “not at all” confident in the safety of COVID-19 vaccines for children. MAHA parents are divided in their confidence in the flu vaccines for children, with about half (54%) saying they are confident. About seven in ten (72%) parents who do not support the MAHA movement are confident in the safety of the flu vaccines.

Parents who support the MAHA movement are more likely than parents who do not support MAHA to hold vaccine skeptical views explored in this survey, though few (9%) would call themselves anti-vaccine. About six in ten (58%) MAHA parents say they are not confident in the CDC and FDA to ensure the safety and effectiveness of vaccines approved for use in the U.S., compared to about half (47%) of non-MAHA parents.

About half (51%) of MAHA-supporting parents say children are healthier when their vaccines are spaced out and they do not get multiple shots in one visit, while about half (47%) correctly say there is no strong evidence for this. Parents who are not supporters of the MAHA movement are more likely to correctly indicate that there is no evidence for spacing vaccines (63%), while one-third (35%) say children are healthier when vaccines are spaced out.

About four in ten MAHA-supporting parents (42%) say the CDC recommends “too many” childhood vaccines, more than twice the share of non-MAHA parents who say the same (17%).

As with parents overall, a majority of MAHA-supporting parents report keeping their children up to date on childhood vaccinations aside from COVID-19 and flu (75%). However, one in four MAHA-supporting parents (24%) report skipping or delaying at least one childhood vaccine for their kids, more than twice the share of non-MAHA-supporting parents who report the same (11%).

Make America Healthy Again and Vaccine Myths

HHS Secretary Kennedy has amplified claims about vaccines that have been rejected by scientists and public health officials, adding to the confusion surrounding their safety. While small shares of parents believe these claims are true, most MAHA parents do not reject them as false, and many express uncertainty.

Though the overall shares are small, MAHA parents are more likely than non-MAHA parents to say it is true that chronic diseases are likely rising because of an increase in the number of vaccines children get (21% vs. 8%), that MMR vaccines can cause autism in children (15% vs. 6%), that the measles vaccine causes the same illness it is supposed to prevent (11% vs. 6%), and that vitamin A is an effective treatment for measles (9% vs. 4%).

About half of MAHA parents say they “do not know enough to say” whether it is true that the measles vaccine causes the illness it is meant to prevent, or that chronic diseases are likely rising because of an increase in the number of vaccines children get, two claims alluded to in the MAHA Commission report. Fewer than four in ten MAHA parents correctly say either of these claims are false (38% and 31% respectively), while a majority of non-MAHA parents identify these as false (57% and 55%).

When it comes to the false claim that MMR vaccines can cause autism in children, nearly six in ten (59%) MAHA parents say they “do not know enough to say” whether it is true, and about one in four (26%) say it is false. Non-MAHA-supporting parents are about twice as likely to correctly indicate that this claim is false (53%). There has been extensive scientific research disproving the link between autism and vaccines.

Views of Autism Research

While there has been extensive scientific research disproving the link between autism and vaccines, there is a lack of consensus on the exact causes for the rise in autism rates in the U.S. The White House MAHA Commission is tasked with studying the root causes of autism.

Many (44%) parents overall say there has been “too little” research into the causes of autism spectrum disorder generally. One in four parents say there has been “about the right amount” of research, and a similar share (28%) say they are not sure. Few (3%) parents say there has been too much research into the topic.

When asked more specifically about the amount of research done into whether there is a link between vaccines and autism spectrum disorder, one-third say there has been “too little” research into this, and similar shares say there has been “about the right amount” (29%) or they are not sure (30%). Few (7%) parents say there has been “too much” research into whether there is a link.

Parents who support the MAHA movement, and Republican parents (including MAGA Republican parents) are more likely than their counterparts to say there has been “too little” research into the causes of autism or whether there is a link between autism and vaccines. In fact, MAHA-supporting parents are twice as likely as non-MAHA parents to say there has been too little research into the connection between autism and vaccines (48% vs. 24%).

While about six in ten parents of children diagnosed with autism spectrum disorder say there has been “too little” research into the causes of autism spectrum disorder generally (61%), fewer – about one-third (35%) – say there has been too little research into whether there is a link between vaccines and autism spectrum disorder. About six in ten parents who have skipped or delayed vaccines for their children say there has been too little research into the causes of ASD (60%) or whether there is a link between vaccines and ASD (57%).

What Do Parents See As the Biggest Threats to Children’s Health in the U.S.?

Social media use, mental health challenges, and issues related to diet and exercise are top issues parents view as serious threats to children’s health in the U.S. At least six in ten parents overall say social media use (75%), highly processed foods (68%), mental health challenges such as chronic anxiety or depression (68%), obesity (64%), gun violence (61%), and lack of physical activity (60%) are either the “biggest” or a “major” threat to children’s health in the U.S. today. About half of parents say pollution, poor air quality, and environmental toxins (53%), over-prescribing medications (50%), and difficulty affording food (46%) are at least major threats to children’s health, while about four in ten cite neurodevelopmental disorders (42%) and infectious diseases (41%) as threats. Fewer (28%) see fluoride in local water supplies as the biggest or a major threat to children’s health.

Despite partisan and demographic differences in who identifies with the MAHA movement, there are some similarities in what parents see as the biggest threats to children’s health. Social media and mental health challenges rank high for both MAHA and non-MAHA-supporting parents when it comes to assessing threats to children’s health, with about three-fourths of MAHA-supporting parents (78%) and non-MAHA-supporting parents (74%) citing social media, and about seven in ten of each group citing mental health challenges.

For issues related to nutrition and exercise, majorities of parents in both groups identify these as threats to children’s health, but MAHA parents are more likely to emphasize their level of threat. MAHA parents are more likely than parents who do not support the movement to say highly processed foods (78% among MAHA parents vs. 62% among non-MAHA parents), obesity (69% vs. 61%), and lack of physical activity (66% vs. 57%) are threats to children’s health. MAHA parents are also more likely to cite over-prescribing medications (61% vs. 43%), neurodevelopmental disorders (48% vs. 38%), and fluoride in water supplies (33% vs. 25%) as the biggest or major threats to children’s health today.

Parents who do not support the MAHA movement, largely comprised of Democratic and independent parents, are more likely to cite gun violence (68% among non-MAHA parents vs. 50% among MAHA parents), pollution (56% vs. 48%), difficulty affording enough food (50% vs. 41%), and infectious diseases (45% vs. 36%) as the biggest or major threats to children’s health in the U.S. today.

Support for Regulating Food Additives

In the past year, Robert F. Kennedy Jr. has called for stricter regulations on the U.S. food supply, requesting the removal of synthetic dyes and ultra-processed foods, citing their negative impact on children’s health. These policy proposals are popular, with at least eight in ten parents saying they “strongly” or “somewhat” support increasing government regulations on dyes and chemical additives in food (85%), on highly processed food (82%), and on added sugars in food (80%). About one in five or fewer parents oppose each of these proposals.

Parents are more divided when it comes to removing government restrictions on the sale of unpasteurized or raw milk, with half (47%) in support and another half (52%) opposed.

About three quarters or more of Democratic parents, independent parents, Republican parents, MAHA-supporting, and non-MAHA-supporting parents support increasing government regulation on food additives, highly processed foods, and sugar. Partisans are divided on the question of raw milk de-regulation, as six in ten Republican (60%) and MAHA-supporting (63%) parents support removal of restrictions on raw milk, while majorities of non-MAHA supporters and Democrats are in opposition. For decades, the FDA has prohibited the interstate sale of raw milk, citing serious health risks posed by the consumption of unpasteurized milk. While Secretary Kennedy has previously accused the FDA of unfairly suppressing the consumption of raw milk, the MAHA Commission report released this year did not include references to raw milk or proposed changes to existing regulations.

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.