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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  • In 73 Percent of Counties, Healthcare.Gov Enrollees Could Lower Their Silver Plan Premiums by Comparison Shopping

    News Release

    A new analysis from the Kaiser Family Foundation finds that in 73 percent of counties served by Healthcare.gov, people enrolled in the lowest-cost silver plan this year could save money on premiums by switching to a different silver plan in 2016. In these counties, the silver plan with the lowest premiums in 2015 is no longer the lowest-cost plan in 2016, according to the analysis. If they stay in their current plan, Healthcare.gov enrollees who…

  • It Pays to Shop: Variation in Out-of-Pocket Costs for Medicare Part D Enrollees in 2016

    Issue Brief

    This analysis focuses on out-of-pocket drug costs for Medicare Part D enrollees in 2016 for specialty, brand, and generic drugs. Part D drug plans differ considerably in the drugs they list on their formularies, their use of formulary tiers, and the level and structure of cost sharing applied to those tiers. Plan decisions affect different beneficiaries in different ways, depending on the drugs they use. The financial consequences for Part D plan enrollees can be…

  • Survey Finds Most Marketplace Enrollees Like Their Coverage, Though Satisfaction with Premiums and Deductibles Has Declined Since 2014

    News Release

    Following the Affordable Care Act’s (ACA) third open enrollment period, a new Kaiser Family Foundation survey of people who buy their own health insurance finds most marketplace enrollees give their coverage good marks, though concerns about premiums, deductibles, and other costs have risen since 2014. The survey, the third in a series, finds about two thirds (68%) of marketplace customers rate their current coverage as either “excellent” or “good.” Although concerns about narrow network plans…

  • Early Analysis of 14 Major Cities Finds Benchmark Silver Plan Premiums in ACA Marketplaces Estimated to Rise 10 Percent on Average in 2017

    News Release

    A Kaiser Family Foundation analysis of Affordable Care Act proposed marketplace rates finds benchmark silver plan premiums are projected to increase 10 percent in 2017 on average across 14 major metropolitan areas. Based on proposed rate filings in 13 states plus the District of Columbia where complete information is currently available, the analysis assesses how premiums for the second lowest-cost silver plan – which is the basis for enrollees’ tax credits -- would change in…

  • Is ACA Coverage Affordable for Low-Income People? Perspectives from Individuals in Six Cities

    Issue Brief

    This brief presents findings from focus groups with low-income Medicaid and Marketplace enrollees in six cities: Baltimore, MD; Columbus, OH; Oakland, CA; Richmond, VA; St. Louis, MO; and Tampa, FL. It explores their experiences signing up for coverage; their perceptions of whether the costs they pay for their coverage are affordable; their experiences accessing care; and the impact of out-of-pocket costs on their ability to get needed care. It provides insights into the ongoing financial…

  • ACA Coverage and the Changing Labor Market: Voices from the Field

    Issue Brief

    This brief highlights voices from adult focus group participants with low and moderate incomes who gained Medicaid or Marketplace coverage following implementation of the ACA. It focuses on work, including work status, the new labor market, job benefits, and the role of ACA coverage for those with non-traditional jobs.

  • Private Health Coverage of COVID-19: Key Facts and Issues

    Issue Brief

    New federal legislation will require most private health plans to cover testing for the coronavirus with no cost sharing. Some states have adopted similar requirements for insurers they regulate, and many private insurance companies will voluntarily expand coverage for testing. However, some private coverage will not be subject to these requirements. To date, fewer changes have been adopted or considered with respect to treatment for complications from the disease. This brief reviews current coverage standards…