Affordability


A promotional image for the the KFF Health Policy 101 Health Care Costs and Affordability chapter

Health Policy 101 is a comprehensive guide covering fundamental aspects of U.S. health policy and programs, including Medicare, Medicaid, the Affordable Care Act, employer-sponsored insurance, the uninsured population, health care costs and affordability, women's health issues, and health care politics. The Health Care Costs and Affordability chapter explores trends in health care costs in the U.S. and the factors that contribute to this spending. It also examines how health care spending varies across the population, the impact of costs on care affordability and individuals' overall financial vulnerability.

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  • Disparities in Access to Air Conditioning And Implications for Heat-Related Health Risks

    Issue Brief

    This analysis examines disparities in access to air condition and their implications. It shows Asian-, Black-, and Hispanic-led households are more likely to report not having an air conditioning unit in their home compared to White households. Lower income households also are more likely than higher-income households to report this and other challenges.

  • How Many People with Employer-Sponsored Insurance Use the Drugs Slated for Medicare Price Negotiations

    Issue Brief

    Among the 167 million people with employer-sponsored insurance in 2022, 3.4 million used at least one of the first 10 drugs identified for Medicare price negotiations, according to a new analysis. The most used drug for people with employer-sponsored health insurance was Jardiance, a drug used to treat diabetes and heart failure, which was taken by more than 911,000 enrollees. The analysis uses the Merative MarketScan 2022 commercial claims to estimate the number of enrollees…

  • What are the Consequences of Health Care Debt Among Older Adults?

    Issue Brief

    Health care debt is a widespread problem in the United States. Medicare offers coverage for a range of health care services, including hospitalizations, physician visits, prescription drugs, and post-acute care, but Medicare beneficiaries generally pay out-of-pocket for their monthly premiums and deductibles, cost-sharing for Medicare-covered services, and the cost of services not covered by Medicare. This data note examines findings from the KFF Health Care Debt Survey to assess the prevalence, sources and consequences of…

  • ACA Marketplace Enrollees Will See Steep Increases in Premium Payments in 2026 if Enhanced Subsidies Expire

    News Release

    Without the enhanced subsidies in the Inflation Reduction Act (IRA), Affordable Care Act (ACA) Marketplace enrollees in 12 of the states that use HealthCare.gov would see their annual premium payments at least double on average, according to a new KFF analysis. Enrollees in three states would see the steepest annual increases: Wyoming (195% or $1,872), Alaska (125% or $1,836), and West Virginia (133% or $1,404), and premiums would rise by an average of 93% or…

  • Unraveling the Mysteries of Biden vs. Trump on Health Care

    From Drew Altman

    In his latest column, KFF President and CEO Drew Altman unravels the differences between Trump and Biden on Medicare, abortion, drug costs and other health-related issues that KFF's new side-by-side candidate analysis examines. From the bird’s eye view, these differences amount to a fork in the road in direction on the role of the federal government in health and federal health spending.

  • Insurer Strategies to Control Costs Associated with Weight Loss Drugs

    Issue Brief

    Affordable Care Act (ACA) Marketplace plans rarely cover GLP-1 drugs approved solely for obesity treatment, according to a an analysis of 2024 federal plan data. Wegovy, a drug that is approved for weight loss, is covered by just 1% of Marketplace prescription drug plans, compared to 82% of Marketplace prescription drug plans for Ozempic, which contains the same active ingredient as Wegovy (semaglutide) but is approved only for diabetes. This analysis examines publicly available formularies…

  • Medical Debt Among New Mothers

    Issue Brief

    This analysis examines the share of new mothers who have significant medical debt (in excess of $250), compared to other young women who did not recently give birth, using data from the Survey of Income and Program Participation (SIPP).