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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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  • A Review of 62 Studies Finds Few Big Differences Between Traditional Medicare and Medicare Advantage on a Variety of Measures

    News Release

    With the Medicare open enrollment period set to begin Oct. 15, a perennial decision faced by Medicare beneficiaries is whether to get their coverage through traditional Medicare or the private plans known as Medicare Advantage. A new KFF review of 62 studies published since 2016 that compares Medicare Advantage and traditional Medicare on measures of beneficiary experience, affordability, utilization, and quality finds few differences that are supported by strong evidence or have been replicated across…

  • Payments to Medicare Advantage Plans Boosted Medicare Spending by $7 Billion in 2019

    News Release

    The federal government spent $321 more per person for beneficiaries enrolled in Medicare Advantage plans than for those in traditional Medicare in 2019, a gap that amounted to $7 billion in additional spending on the increasingly popular private plans that year, finds a new KFF analysis. The Medicare Advantage spending includes the cost of extra benefits, such as vision, dental and hearing coverage that are funded by rebates and not covered for beneficiaries in traditional…

  • Poll: Family Members of Older Adults with Serious Illness Are More Confident That They Know Their Medical Wishes When They Have Written Documents

    News Release

    Most Seriously Ill Seniors Struggle with Cognitive and Mental Health Challenges; Nearly Half Reportedly Have Problems Understanding Drug and Medical Instructions Seniors with serious illness and their families are more likely to feel their wishes for medical care are being followed when they have written them down, finds a new Kaiser Family Foundation survey on the public’s views and experiences with illness in late life. As America grows older and more people face serious illness…

  • What Do State Plans Reveal About Their Readiness to Distribute COVID-19 Vaccines? 

    News Release

    With hopes that a COVID-19 vaccine or vaccines will be proven safe and effective soon, state and local public health authorities will play a critical role in ensuring the efficient distribution and administration of the vaccine. To assess the readiness of these local governments to take on these responsibilities, KFF reviewed the preliminary vaccine distribution plans submitted to the U.S. Centers for Disease Control and Prevention last month by the states and the District of…

  • Analysis: A Proposal Like Biden’s Health Plan Would Lower the Cost of ACA Marketplace Coverage for Nearly All Potential Enrollees and Lower Premiums for Over 12 Million Workers With Employer Coverage

    News Release

    A new KFF analysis finds that expanding Affordable Care Act (ACA) premium subsidies like Democratic presidential nominee Joe Biden has proposed would lower the cost of Marketplace coverage for nearly all potential enrollees, including the uninsured and others currently priced out of the Marketplace. While the former Vice President’s plan to create a public option has received substantial public attention, his companion proposal to expand ACA marketplace subsidies has been less discussed, even as it…

  • FAQs on Medicare Coverage and Costs Related to COVID-19 Testing and Treatment

    Issue Brief

    These FAQs provide the latest guidance on testing and treatment related to COVID-19 for Medicare beneficiaries, including questions related to out-of-pocket costs, the COVID-19 vaccine, telehealth, extended supplies of medication, skilled nursing facility stays, and issues for people in private Medicare Advantage plans.

  • What to Know About the FDA’s Recent Decision to Allow Florida to Import Prescription Drugs from Canada

    Policy Watch

    Florida’s plan to import certain prescription drugs from Canada represents the first time the Food and Drug Administration (FDA) has granted authority for a state to safely import prescription drugs from another country. This policy watch analysis unpacks some frequently asked questions related to state of Florida’s importation plan, including potential obstacles to implementation, who will benefit from any savings, and what types of drugs will (and will not) qualify for importation.

  • Visualizing Health Policy: The Costs and Outcomes of Mental Health and Substance Use Disorders in the US

    News Release

    This Visualizing Health Policy infographic looks at costs and outcomes of mental health and substance use disorders in the United States (US). Nearly 18% of adults reported having a mental, behavioral, or emotional disorder in 2015, including more than 1 in 5 women. Furthermore, nearly 3% of people aged 12 years or older reported addiction to or misuse of an illicit drug in 2015, including more than 7% of people aged 18 to 25 years.…

  • State Actions to Improve the Affordability of Health Insurance in the Individual Market

    Issue Brief

    A number of states have taken steps to provide consumers with more affordable coverage options in the individual market, including the marketplaces. Some states are implementing strategies that lower premiums by building on, and increasing the stability of the individual market, while other states are expanding the availability of lower cost coverage sold outside the marketplaces that does not comply with ACA standards—an approach that could increase marketplace premiums further. This brief examines these different…

  • Survey of Non-Group Health Insurance Enrollees, Wave 3

    Poll Finding

    The survey, conducted shortly after the close of the Affordable Care Act’s third open enrollment period, is the third in a series exploring the experiences of individuals who purchase their own health insurance in the nongroup market, including coverage purchased both inside and outside the ACA’s marketplaces. It examines enrollees’ satisfaction with their health plans’ premiums, deductibles, and provider networks, their views on affordability, shopping experiences, and problems encountered with their plans.