Since Roe v. Wade was overturned in June 2022, there has been considerable media attention and legal scrutiny of the health and life exceptions to state abortion bans. This may emerge as an election issue as Former President Trump has stated that he supports rape exceptions to abortion bans, but the 2024 Republican party platform says states should decide their own abortion laws – with no mention of exceptions. The vast majority of Americans – about 8 in 10 – support legal access to abortion for pregnancies resulting from rape or incest. While rape and incest exceptions have been part of the political debate, the feasibility of accessing abortion care under these exceptions has garnered much less attention.

Despite broad support for legal access to abortion in cases of rape or incest, 10 of the 21 states with abortion bans or gestational limits do not have an exception for pregnancies resulting from sexual assault. In the 11 states with rape and incest exceptions, lack of provider availability, law enforcement reporting requirements, and early pregnancy gestational limits can make access to abortion care unattainable for pregnant survivors of sexual assault (Figure 1).

Rape and incest exceptions to state abortion bans or gestational limits are often restricted to abortion early in pregnancy. Among the 21 states with abortion bans or early gestational limits, 11 make exceptions for pregnancies resulting from rape or incest and 10 do not. Of the 14 states with total abortion bans, nine (Alabama, Arkansas, Kentucky, Louisiana, Missouri, Oklahoma, South Dakota, Tennessee, and Texas) lack a rape or incest exception. The remaining 5 (Idaho, Indiana, Mississippi, North Dakota, and West Virginia) have exceptions for cases of rape or incest but limit these exceptions to the earlier stages of pregnancy. Most pregnant people discover they are pregnant at 5.5 weeks LMP, though people living on lower incomes, younger people, Black and Hispanic people, and those experiencing unintended pregnancies often discover their pregnancies later. Of the 7 states with overall gestational limits between 6 and 15 weeks LMP, six (Florida, Georgia, Iowa, Nebraska, North Carolina, and South Carolina) have rape or incest exceptions. Arizona does not have a rape or incest exception in its law.

Most rape or incest exceptions require involvement of law enforcement, which can restrict abortion access for those who have become pregnant as a result sexual assault. In 5 of the states with rape or incest exceptions – Florida, Georgia, Idaho, Mississippi, and West Virginia – pregnant people must report the sexual assault to law enforcement before they can receive abortion care. Many of these states additionally require that the pregnant person provide the physician a copy of the report ahead of receiving care. In Iowa, sexual assault survivors must report the incident “to law enforcement or a public or private health agency which may include a family physician”– within 45 days of the incident (140 days for cases of incest). In South Carolina, survivors are not required to report their assault to law enforcement before receiving abortion care, but physicians who perform abortions under the rape/incest exception must report the allegation of sexual assault to the sheriff in the county in which the abortion was provided.

It is estimated that only 21% of sexual assaults are reported. Survivors are often afraid to report sexual violence to the police due to fear of retaliation and the belief that law enforcement would not do anything to help.

These requirements can also delay care. There are no clear guidelines specifying how quickly law enforcement must issue a copy of the report in these states. Advocates argue it is difficult to get a copy of a police report while the sexual assault is still being investigated. Among the states that require law enforcement reporting, only Idaho specifies that survivors of sexual assault are entitled to receiving a copy of the report within 72 hours of making the request.

Pregnant people may face difficulty finding an abortion provider or securing an appointment. In states with total abortion bans, few abortion providers remain. Providers in states with early gestational limits (and the few remaining providers in states with total bans) may be unwilling  to provide abortion care in instances of rape or incest – even when there is an exception – out of fear of prosecution. The sexual assault exceptions often do not specifically outline how physicians can ensure that they will not be prosecuted for providing an abortion that falls under the exceptions. In Idaho, Mississippi, and North Dakota clinics and abortion funds have counseled patients to leave the state to obtain abortion care because they have found that it is easier for people to obtain abortion care out of state than to attempt to receive care in-state under the exception.

It is instructive to consider a hypothetical scenario in West Virginia, an abortion ban state with a rape/incest exception.  The state’s total abortion ban has an exception for pregnancies resulting from rape or incest, but only up to 8 weeks LMP (Last Menstrual Period) for adults, typically about 4 weeks after a missed period. Because most people discover they are pregnant at 5.5 weeks LMP, a person who is pregnant as a result of rape or incest in West Virginia typically would have only 2.5 weeks to:

1. Find and secure and appointment with a physician who is willing and able to provide the abortion
2. File a report of the assault to law enforcement and retrieve a copy of the report to provide to the physician performing the abortion at least 48 hours before receiving the abortion
3. Secure sufficient funding to pay for the abortion
4. Manage other logistical challenges, such as arranging childcare and time off work.

West Virginia’s ban is layered on top of the abortion restrictions implemented before the Dobbs decision: a 24-hour waiting period, mandatory counseling, an ultrasound offer, and for minors, parental or legal guardian notification or a judge’s approval.  The flow chart below shows how tight this timing is. (Figure 2)

Medicaid coverage for abortion care may be inaccessible, even for enrollees who qualify for a rape or incest exception. Although the federal Hyde Amendment requires state Medicaid programs to cover abortions in cases where the pregnancy resulted from rape or incest, many state Medicaid programs impose pre-authorization requirements and medically unnecessary restrictions. As a result, few, if any, pregnant people obtain Medicaid coverage for their abortion care.  For low-income survivors of sexual assault, cost can be an insurmountable barrier to accessing abortion care. In 2021, the median cost of abortion services exceeded $500. However, 43% of women ages 18-49 cannot cover an emergency expense of at least $500 using their current savings, with even larger shares of Black and Hispanic women (57% and 58%, respectively) being unable to cover such an emergency medical expense.

Few people have accessed abortion care under the rape or incest exceptions to state abortion bans. While data from states with abortion bans and exceptions for rape or incest is scant, estimates show that very few abortions are provided in states with total abortion bans, even in those with sexual assault exceptions. For example, Mississippi and Idaho each had 5 documented abortions in 2023, though neither specify the exception under which the abortions were provided. In West Virginia, 23 abortions were provided from January 2023 through June 2024, but none are reported to have been provided under the state’s rape/incest exception. Since Indiana’s total ban went into effect in late August 2023, providers have reported that 5 abortions were provided due to rape or incest.  The true number of pregnancies that result from rape is unknown. Given the extremely low number of abortions states have reported as qualifying for rape exceptions to abortion bans and what is known about the high rates of sexual violence that women experience, it would appear that these exceptions have not provided the level of access to abortion for pregnant rape survivors that the laws presumably are designed to protect.

Note: This factsheet was updated on October 08, 2024 to incorporate new data on HPV vaccine utilization.The human papillomavirus (HPV) vaccine is the first and only vaccination that helps protect individuals from getting several cancers that are associated with different HPV strains. The vaccine protects young people against infection from certain strains of HPV, the most common sexually transmitted infection (STI) in the United States. Since HPV vaccines were first introduced in the U.S. in 2006, there have been changes in the range of protection they offer and the dosing regimen. The vaccines were originally recommended only for girls and young women and were subsequently broadened to include boys, young men, and people of all genders. This factsheet discusses HPV and related cancers, use of the HPV vaccines for both females and males, and insurance coverage and access to the vaccines.

HPV and Cancer

HPV is the most common STI in the U.S. and is often acquired soon after initiating sexual activity. Approximately 42.5 million Americans are infected with HPV and there are at least 13 million new infections annually. There are more than 200 known strains of HPV, and while most cases of HPV infection usually resolve on their own, persistent infection with high-risk strains can cause cancer. HPV-related cancers have increased significantly in the past two decades — between 2015 and 2019, over 47,000 people in the United States developed an HPV-related cancer compared to 30,000 in 1999. While HPV-related cervical and vaginal cancer rates have decreased since 1999, rates for oropharyngeal and anal HPV-related cancers have increased.

Cervical Cancer

HPV is related to over 90% of cervical cancer cases, with two strains (16 and 18) responsible for approximat­­ely 66% of cervical cancer cases worldwide. In the U.S., it is estimated that 13,820 new cervical cancer cases will be diagnosed in 2024. While cervical cancer is usually treatable, especially when detected early, approximately 4,360 deaths from cervical cancer will occur in 2024. Current guidelines by the U.S. Preventive Services Task Force (USPSTF) and Women’s Preventive Services Initiative (WPSI) recommend that most women ages 21 to 65 receive Pap test once every three years and recommends that women over 30 get a high-risk HPV test every 5 years.

Despite widespread availability of Pap testing, racial disparities in cervical cancer incidence and mortality rates persist in the U.S. For example, although Hispanic women have the highest incidence rate of cervical cancer, their cervical cancer mortality rates are comparable to the national mortality rate. Black women, on the other hand, have the third highest incidence rate of cervical cancer, yet have the highest mortality rates of the disease (Figure 1). One notable paradox is that Black women also have the highest rates of recent Pap testing. In 2022, 64% of Black women ages 18 to 64 reported having received a Pap smear in the past two years compared to 59% of White women, 60% of Hispanic women, and 57% of Asian women. Lower rates in follow-up treatment after an abnormal pap smear, differences in treatment options, diagnosis at later stages of disease progression, and distrust in the medical system may account for some of the disproportionate impact of cervical cancer on Black women.

More than half of cervical cancer cases are detected in women who have never been screened or have not been screened as frequently as recommended in guidelines. Higher shares of Hispanic and Black women have never been screened for cervical cancer compared to White women (14% and 12% percent, respectively, compared to 6% of White women). Additionally, Hispanic women have one of the highest uninsured rates in the country (20%) compared to 6% of White women and 10% of Black women. Compared to women with insurance, uninsured women and women with Medicaid were less likely to access preventive health services such as Pap tests in 2022.

Cervical cancer screening rates declined during the early part of the COVID-19 pandemic. While cervical cancer screening rates have rebounded to a degree, they have not returned to pre-pandemic levels. A KFF survey of OBGYNs found that 71% of physicians reported that it was difficult to provide preventive reproductive health care services, like STI and cervical cancer screenings, during the COVID-19 pandemic. In that same survey, 38% of OBGYNs said they were somewhat or very worried that their patients who experienced delays in following up on abnormal pap smears because of the pandemic would face negative health care consequences.

In May 2024, the U.S. Food and Drug Administration (FDA) approved the use of HPV self-collection methods in healthcare settings, though these methods are not yet widely available. Self-collection will allow women to collect a vaginal swab sample within a healthcare facility without having to see a gynecologist. However, they would not replace screening with pap tests or traditional HPV testing; rather, they would provide patients with a more private, comfortable, and convenient option to test for cervical cancer as well as improve earlier detection of the disease. Currently, the National Cancer Institute is conducting a study to gauge the usability, acceptability, and effectiveness of self-collection methods throughout the United States.

Oropharyngeal and Anal Cancers

Approximately 20,805 cases of oropharyngeal (throat) cancer occur annually in the U.S, most of which (70%) are probably caused by HPV. Oropharyngeal cancers are the most common HPV-associated cancer among men and are more common among men than women (Figure 2). However, it’s important to note that anyone who heavily uses both tobacco and alcohol is at much higher risk of developing these cancers. Research suggests that HPV vaccines can help protect against throat cancer, since many are associated with HPV 16 and 18, two of the strains that the vaccine protects against.

HPV is also responsible for the majority (91%) of the over 7,500 annual cases of anal cancer in the U.S. Most cases of anal cancer are among women (Figure 2), but men who have sex with men are also at higher risk of HPV strains 16 and 18. Additional risk factors for anal cancer include a history of cervical cancer and having a suppressed immune system. Like oropharyngeal cancer, there has been an increase in the rate of anal cancers in the past 15 years.

HPV Vaccines

Since 2016, Gardasil®9 is the only HPV vaccine available in the U.S. The HPV vaccine, as well as all other routine vaccines, may be administered on the same day as any of the COVID-19 vaccines.

The FDA approved first-generation Gardasil®—produced by Merck—in 2006, which prevented infection of four strains of HPV: 6, 11, 16, and 18. In December 2014, Gardasil®9 was approved by the FDA. This vaccine protects against 9 strains of HPV: the four strains approved in the previous Gardasil vaccine, as well as 31, 33, 45, 52, and 58. These strains are associated with the majority of cervical cancer, anal cancer, and throat cancer cases as well as most genital warts cases and some other HPV-associated ano-genital diseases. The vaccine was initially approved for cervical cancer prevention, but in 2020 the FDA broadened its approval to include the prevention of oropharyngeal cancer and other head and neck cancers.

Gardasil®9 has been approved by the FDA for use in individuals ages nine to 45 years (Table 1). The federal Advisory Committee on Immunization Practices (ACIP)—an independent body of experts that issues immunization recommendations for the U.S. population—recommends that all girls and boys get vaccinated at age 11 or 12, or as early as age nine, and that adolescents and young adults ages 13 to 26 be given a “catch-up” vaccination series. ACIP recommends a two-dose series over 6 to 12 months for individuals who received their first vaccine at ages nine to 14. Teens and young adults who initiate vaccination at age 15 or older should receive three doses over six months. These recommendations are designed to promote immunization when the vaccine is most effective – before the initiation of sexual activity. Those already infected with HPV can also benefit from the vaccine because it can prevent infection against HPV strains they may not have contracted, but the vaccine does not treat existing HPV infections.

While the FDA expanded it’s approval of the HPV vaccine to include adults ages 27 to 45, ACIP does not recommend routine catch-up vaccinations for all adults in this age group. ACIP recommends that adults ages 27 to 45 who have not been properly vaccinated and who may be at risk for new HPV infections consult with a medical professional about receiving the vaccine.

Current global research suggests Gardasil®9 protection is long-lasting: more than 10 years of follow-up data in both boys and girls indicate the vaccines are still effective and there is no evidence of waning protection, although it is still unknown if recipients will need a booster in the future. Other HPV vaccines show similar effectiveness. In Scotland, recipients of the bivalent HPV vaccine Cervarix®—which protects against HPV 16 and 18—who became fully vaccinated against HPV at age 12 or 13 have had no cases of cervical cancer since the vaccine program started in 2008. Additionally, new data from the American Society of Clinical Oncology shows that the vaccine reduced the risk of all HPV-associated cancers—including oropharyngeal, head, and neck cancers—by 50% in men.

Outreach and Utilization

HPV vaccination rates vary by state, from a low of 39% of adolescents being HPV UTD in Mississippi to a high of 85% in Rhode Island (Figure 3). Some states, such as Hawaii, Rhode Island, Virginia, and D.C., have laws that require HPV vaccination for school entry. In California, the Cancer Prevention Act requires schools to notify families of 6^th grade children about HPV vaccine recommendations and advise them to follow guidelines but does not require them to adhere to them for school entry. Vaccine exemptions due to religious or personal beliefs are permitted in most states.

Some people begin the vaccine series but do not complete it. In 2023, 78.5% of adolescent girls and 75% of boys received at least one dose of the HPV vaccine. Trends in vaccination coverage show that overall HPV vaccination initiation slightly declined in 2022 for the first time since 2013 among some subgroups of adolescents aged 13-17. While vaccine initiation among adolescents overall remained steady, initiation rates in 2022 decreased among adolescents who were uninsured or covered by Medicaid (Figure 4).

Data from the Vaccines for Children Program (VFC), a federally-funded program that covers the cost of ACIP-recommended vaccines for eligible populations through age 18, show that, compared to 2019, VFC provider orders for the HPV vaccine decreased from 2020 to 2022. Research suggests that the COVID-19 pandemic disrupted the delivery and administration of the HPV vaccine, as well as parents’ and patients’ abilities to attend well-child visits before vaccines became overdue, resulting in lower rates of vaccination.

Vaccine hesitancy during this time may have also contributed to the decline in HPV vaccine initiation. Prior to the COVID-19 pandemic, parents’ top reasons for not vaccinating their children were perceptions of safety concerns and the belief that the vaccine was not needed. Since the COVID-19 pandemic began, some providers have observed an increase in vaccine hesitancy or refusal in parents of adolescents due to difficulties caused by COVID-19 or mistrust in vaccines.

Compared to 2022, national HPV UTD rates among adolescents aged 13-17 remained steady in 2023, with just over 60% being up-to-date. HPV vaccination rates among teen boys are lower than for girls (59% vs. 64% HPV UTD in 2023), but they have been rapidly rising since 2016.  Although HPV UTD rates in adolescents overall has remained steady, recent data shows a decline in vaccination rates by birth year. Compared to 13-year-olds born in 2007, HPV UTD coverage in 13-year-olds born in 2010 decreased by 7.1% overall and 10.3% among those eligible for the VFC program. The Centers for Disease Control and Prevention (CDC) suggest that additional outreach focused on populations that experienced declines in vaccination is needed to further understand the impact of the COVID-19 pandemic on access to and initiation of recommended vaccines.

Vaccine Financing

There are multiple sources of private and public financing that assure that nearly all children and young adults in the U.S. have coverage for the HPV vaccine. Many of the financing entities base their coverage on ACIP recommendations.

The Affordable Care Act (ACA) requires public and private insurance plans to cover a range of recommended preventive services and ACIP recommended immunizations without consumer cost-sharing. Plans must cover the full charge for the HPV vaccine, as well as pap tests and HPV testing for women.

Public Financing

Vaccines for Children — Through the VFC program, the CDC purchases vaccines at a discounted rate and distributes them to participating healthcare providers. All children are eligible through age 18 if they are uninsured, underinsured, Medicaid-eligible, Medicaid-enrolled, or American Indian or Alaska Native.

Medicaid — Medicaid covers ACIP recommended vaccines for enrolled individuals under age 21 through the Early and Periodic Screening Diagnosis and Treatment program (EPSDT). Adults 21 and older who are insured through Medicaid are covered for approved adult ACIP-recommended vaccinations without cost-sharing.

Public Health Service Act — Section 317 of the Public Health Service Act provides grants to states and local agencies to help extend the availability of vaccines to uninsured adults in the United States. These are often directed towards meeting the needs of priority populations, such as underinsured children and uninsured adults.

Merck Vaccine Patient Assistance Program — Merck has established assistance programs to provide free vaccines in the United States. To qualify, individuals must be aged 19 or older, uninsured, and low-income.

Children’s Health Insurance Program (CHIP) — Children who qualify for CHIP are part of families whose incomes are too high to qualify for Medicaid but too low to afford private insurance. Each state has its own set of specific qualifications for CHIP. The program is managed by the states and is jointly funded by the states and the federal government. CHIP programs that are separate from the Medicaid Expansion must cover ACIP-recommended vaccines for beneficiaries since they are not eligible for coverage under the federal VFC.

The HPV vaccine has been available in the U.S. for nearly two decades and uptake has risen over that time, though more recently since the COVID-19 pandemic there have been notable declines in vaccination rates. Since its introduction in 2006, the vaccine covers more strains of HPV, its use has been extended to males, the dosage has dropped from three to two shots, and the cost is fully covered by private insurance and public programs. With these improvements, the vaccine holds the promise to safely and dramatically reduce the rates of and prevent many kinds of cancers that have long been responsible for the deaths of women and men.

The Senate Committee on Appropriations approved its FY 2025 Labor, Health and Human Services, Education, and Related Agencies (Labor HHS) appropriations bill, accompanying report, and amendments on August 1, 2024. The Labor HHS appropriations bill includes funding for U.S. global health programs provided to the Centers for Disease Control and Prevention (CDC) and funding for global health research activities provided to the National Institutes of Health (NIH). Total global health funding at CDC and NIH through the Labor HHS bill is not yet known, as funding for some programs at NIH is determined at the agency level rather than specified by Congress in annual appropriations bills. Funding for global health programs at CDC totals $698 million, which is $4.8 million (1%) above the FY24 enacted and President’s FY25 request level ($693 million) and $134 million (24%) above the House level ($564 million). Funding for parasitic diseases and global public health protection at CDC increased while all other program areas, including the Fogarty International Center at NIH, remained flat compared to the FY24 enacted amounts. See the table below for additional detail on global health funding. See other budget summaries and the KFF budget tracker for details on historical annual appropriations for global health programs.

The Senate Committee on Appropriations approved the FY 2025 State, Foreign Operations, and Related Programs (SFOPs) appropriations bill, accompanying report, and amendments on July 25, 2024. The SFOPs bill includes funding for U.S. global health programs at the State Department and the U.S. Agency for International Development (USAID). The SFOPs bill includes funding for U.S. global health programs at the State Department and the U.S. Agency for International Development (USAID). Funding for these programs, through the Global Health Programs (GHP) account, which represents the bulk of global health assistance, totaled $9.7 billion, a decrease of $886 million (-8%) below the FY 2024 enacted level. All of the decrease is due to reduced funding in the bill for the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), though the accompanying report notes that the decline is “a result of the statutory cap on U.S. contributions related to other donor funds.” Funding for maternal and child health, UNICEF, nutrition, family planning and reproductive health (FP/RH), global health security, the Health Reserve Fund, and Global Health Worker Initiative increased compared to FY 2024 enacted levels; all other global health areas remained flat. The bill also included an extension of PEPFAR from March 25, 2025 to September 30, 2026. See the table below for additional detail on FY 2025 Senate levels compared to the FY 2024 Omnibus as well as the FY 2025 President’s Request and FY 2025 House levels. See other budget summaries and the KFF budget tracker for details on historical annual appropriations for global health programs.

ACA Marketplace insurers are proposing a median premium increase of 7% for 2025, similar to the 6% premium increase filed for 2024, according to a new KFF analysis of the preliminary rate filings. Insurers’ proposed rate changes – most of which fall between 2% and 10% – may change during the review process.

Although the vast majority of Marketplace enrollees receive subsidies and are not expected to face these added costs, premium increases generally result in higher federal spending on subsidies. The justifications insurers provide for these premium changes also shed light on what is driving health spending more broadly.

Insurers cite growing health care prices – particularly for hospital care – as a key driver of premium growth in 2025, as well as growing use of weight loss and other specialty drugs, according to KFF’s examination of publicly-available documents.

This year, increases in the prices insurers are paying for medical care tend to affect premiums more than growth in the utilization of care. Insurers say workforce shortages and hospital market consolidation, which can put upward pressure on health care costs and prices, are increasing 2025 health insurance premiums.

Meanwhile, growing demand for Ozempic, Wegovy, and other costly GLP-1 drugs, which are used to treat diabetes and obesity, is increasing prescription drug spending.

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.

This updated analysis of insurers’ preliminary rate filings shows that ACA Marketplace insurers are requesting a median premium increase of 7% for 2025, similar to the 6% premium increase filed for 2024. Insurers cite growing health care prices – particularly for hospital care – as a key driver of premium growth in 2025, as well as growing use of weight loss and other specialty drugs, according to KFF’s examination of publicly-available documents.

Insurers’ proposed rate changes – most of which fall between 2% and 10% – may change during the review process. Although the vast majority of Marketplace enrollees receive subsidies and are not expected to face these added costs, premium increases generally result in higher federal spending on subsidies.

The analysis can be found on the Peterson-KFF Health System Tracker, an information hub dedicated to monitoring and assessing the performance of the U.S. health system.

An updated issue brief looks at the drivers of health spending in the U.S. and key differences between the U.S. and other large, wealthy nations. The analysis finds that people in the U.S. spent $5,683 more per person on health care compared to those in similarly large and wealthy countries. Almost 80% of the difference in spending came from inpatient and outpatient care costs. Many retail prescription drugs also cost more in the U.S. In 2021, the U.S. spent $1,635 per capita on prescription drugs, including over-the counter drugs, while comparable countries spent $944 on average

The analysis is 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.

A new KFF analysis shows that the share of young adults (ages 18 to 26) receiving mental health treatment rose by 45% between 2019 and 2022 – a steeper increase than in any other age group.

More than 1 in 4 young adults (26%) received counseling and/or medication for mental health concerns in 2022, up from 18% three years earlier, according to the analysis of the most up-to-date National Health Interview Survey (NHIS) data available.  That was a higher share than among adults in any other age group in 2022.

While other age groups experienced an increase in the share receiving treatment over the period as well, the increase was smaller: 29% for adults ages 27-50, 13% for adults ages 51-64, and 1% for adults 65 and above.

The spike in utilization among young adults roughly coincided with the onset and most challenging years of the COVID-19 pandemic – when school and work were significantly disrupted – although utilization of mental health services had been increasing even before the pandemic. Even so, research shows that among young adults with mental health conditions, many still report not receiving treatment.

Overall, 23% of adults received mental health treatment in 2022, up from 19% in 2019, the analysis showed. Specifically, the share of all adults saying they received mental health counseling rose from 10% in 2019 to 13% in 2022. At the same time, the share of adults reporting they took prescription medication for mental health conditions increased from 16% to 19%.

The analysis shows that women were nearly twice as likely as men to report receiving mental health treatment in the past year (29% vs. 17% in 2022). Other research suggests that men may be less likely to seek mental health care than women, and they are more likely to be uninsured and less likely to report a usual source of health care.

Other key takeaways include:

• Across racial and ethnic groups, the share of people who said they received mental health treatment in 2022 was highest among White adults (28%) and lowest among Asian adults (9%). That compared to 16% each among Hispanic adults and Black adults.
• Adults with insurance coverage are more likely to report receiving mental health care in the past year than adults without insurance coverage (25% vs. 11% in 2022).

Many people in the United States experience mental health conditions, which raises questions about mental health service utilization patterns and what barriers exist with connecting people to services. Prior research suggests that mental health service utilization increased over time. This analysis explores more recent data, from 2019 to 2022, to understand the latest trends in utilization of mental health services and how it differs by demographics and insured status. In this analysis, receipt of mental health care is measured as the share of people who say they received mental health counseling and/or prescription medication for mental health concerns in the last year. Estimates shown are KFF analyses of National Health Interview Survey (NHIS) data among adults in the U.S. from 2019 to 2022.

In 2022, 23% of adults received mental health treatment, up from 19% in 2019 (Figure 1). Specifically, the share of adults saying they received mental health counseling in the past year increased from 10% in 2019 to 13% in 2022. Similarly, the share of adults reporting they took prescription medication for mental health conditions increased from 16% to 19% during the same period. Receipt of prescription medication remained consistently higher than counseling (19% vs. 13%, respectively, in 2022).

Compared to older adults, young adults (ages 18-26) were more likely to receive mental health treatment and experienced the highest increase in receipt of treatment over time. In 2022, 26% of young adults reported receiving counseling and/or prescription medications for mental health conditions in the past year, representing a significantly higher share compared to all other adults (ages 27 and above) (Figure 2).

Young adults also experienced the largest percent increase in the share of adults receiving mental health treatment from 2019 to 2022 (45%), followed by adults ages 27-50 (29%), 51-64 (13%), and 65 and above (1%) (Figure 2). Although receipt of mental health services has increased among young adults in recent years, other KFF analyses found that leading up to the pandemic, many young adults with mental health conditions did not receive treatment. The lack of treatment among this population may be linked to costs, transitioning from pediatric to adult health care, and difficulties accessing mental health services in college settings.

Women are nearly twice as likely to report receiving mental health treatment in the past year compared to men. In 2022, 29% of women reported receiving mental health services, compared to 17% of men (Figure 3). Research suggests men may be less likely to seek mental health care than women. Men are also more likely to be uninsured and less likely to report a usual source of health care. Separately, women are more likely than men to report experiencing mental health disorders, including serious mental illness.

Across racial and ethnic groups, past year receipt of mental health treatment was highest among White adults and lowest among Asian adults. In 2022, 28% of White adults reported receiving counseling and/or prescription medication for mental health conditions in the past year, compared to 16% of Hispanic and Black adults and 9% of Asian adults. A recent KFF poll found that, compared to their White peers, Hispanic, Black, and Asian adults disproportionately report challenges with mental health care utilization, including finding a provider who can understand their background and experiences, lack of information, and stigma or embarrassment. Additionally, the lack of a diverse mental health care workforce, absence of culturally informed treatment options, and stereotypes and discrimination associated with poor mental health may also contribute to limited mental health treatment among Black and Asian adults. Specifically among Asian people, cultural attitudes towards mental health are a factor that may lead to both lower reporting of mental health concerns and lower service utilization.

Adults with insurance coverage are more likely to report past year receipt of mental health care than adults without insurance coverage (25% vs. 11% in 2022, Figure 5). Despite higher utilization of mental health care over time – driven by insured adults – challenges remain with accessing services. For instance, KFF’s 2023 Consumer Survey found that 43% of insured adults with mental health concerns said there was a time in the past year when they did not get the mental health treatment they thought they needed, and 45% gave their insurance a negative rating for the availability of mental health providers. Further, KFF’s 2023 Employer Health Benefits Survey found that among employers offering health benefits, a higher share reported having a sufficient number of primary care providers in their plan’s networks (91%) compared to those who reported having a sufficient number of behavioral health care providers (67%).