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COSTS and Affordability

KFF Health Tracking Poll: Health Care Costs and the Midterms

This KFF poll finds that health care costs continue to top the public’s list of affordability worries, even as concerns about gas prices have risen in recent weeks, with two-thirds of the public expressing worry over affording health care costs. Majorities say health costs will influence their vote this election. Voters favor Democrats on the issue, while Republicans hold an advantage on addressing fraud and abuse.

Affordable care act

ACA Marketplace Survey Feature Image - Website

Cost Concerns and Coverage Changes: A Follow-Up Survey of ACA Marketplace Enrollees

This KFF survey is a follow-up survey of adults who had ACA Marketplace insurance in 2025. The survey examines the cost concerns and coverage changes of Marketplace enrollees following the end of the enhanced premium tax credits and finds that half of returning enrollees say their health care costs are “a lot higher” and most expect to cut back on basic household expenses to afford coverage.

Health System Tracker

What Are the Recent Trends in Employer-Based Health Coverage? Employer-sponsored health insurance is the largest source of health coverage for people under 65, but its reach is uneven.

How Does U.S. Life Expectancy Compare to Other Countries? The life expectancy gap between the U.S. and peer countries decreased from 4.1 years in 2023 to 3.7 years in 2024 as U.S. mortality dropped.

How Does Cost Affect Access to Health Care? In 2024, about 1 in 6 adults reported delaying or not getting healthcare due to cost, including medical or mental health care.

How Does Health Spending in the U.S. Compare to Other Countries? While the U.S. still spends the most in total dollars, eight OECD nations had a higher percentage increase in per-person health spending in 2024.

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  • The Real Cost of Health Care: Interactive Calculator Estimates Both Direct and Hidden Household Spending

    News Release

    A new interactive tool from KFF estimates total household health spending for individuals and families in the U.S., including costs that are often less visible to consumers. Users can generate scenarios based on family size, income level, insurance source, and health status. In addition to estimating direct costs like deductibles and copayments, the tool highlights indirect spending on health care, such as state and federal taxes paid to fund public programs like Medicare and Medicaid,…

  • Household Health Spending Calculator

    Interactive

    This interactive tool, updated with 2022 data, helps users understand health care costs vary by family size, income, insurance, and health status. Use the dropdown menus to explore scenarios and trends in household health spending.

  • Poll: Most Americans Don’t Realize How Dramatically the Medicare-for-all Proposals Would Revamp the Nation’s Health Care System

    News Release

    As Congress and the Democratic presidential candidates continue to discuss Medicare-for-all and other proposals to expand public health coverage, most Americans know little about how the leading Medicare-for-all proposals would reshape the way all Americans get and pay for health care. This month’s KFF Health Tracking Poll probes the public’s awareness of key elements of proposals to create a national health plan, including the leading Medicare-for-all bills introduced by Sen. Bernie Sanders and Rep. Pramila…

  • Data Note: Prescription Drugs and Older Adults

    Issue Brief

    This data note explores the attitudes and experiences of older adults, ages 65 and up, when it comes to prescription drugs and related policy proposals being discussed. Experiences across different demographic groups are explored, such as household income and health status.

  • New Analysis of Large Employer Health Coverage: The Cost to Families for Health Coverage and Care Has Risen More Than 2X Faster Than Wages and 3X Faster Than Inflation Over the Last Decade 

    News Release

    A new KFF analysis that looked at both premiums and other out-of-pocket costs shows that families with coverage through a large employer paid 67 percent more for their health benefits and care in 2018 than a decade earlier. In 2018, a typical family of four with large employer coverage spent $4,706 on their share of health premiums and $3,020 on cost sharing (such as deductibles, copayments and coinsurance) for a combined cost to the family…

  • Poll: Most Democrats Prefer a Presidential Candidate Who Wants to Build on the Affordable Care Act

    News Release

    The latest KFF Health Tracking Poll probes Democrats’ views about the general approaches to expanding health coverage and lowering costs put forward by the candidates. Most Democrats and Democratic-leaning independents (55%) say they prefer a candidate who would build on the Affordable Care Act to achieve those goals. Fewer (40%) prefer a candidate who would replace the ACA with a Medicare-for-all plan. Even among those who prefer a candidate who would replace the ACA with…

  • Section 3: Employee Coverage, Eligibility, and Participation

    Report

    Employers are the principal source of health insurance in the U.S., providing health benefits to about 63% of nonelderly persons in 2002.4 Although the percentage of workers receiving health insurance through their own employer has exhibited only slight annual declines, the cumulative drop since 2001 is over four percentage points. The majority of this decline is among all small firms (3-199 workers). As a consequence, we estimate that there are at least five million fewer…

  • Massachusetts Health Care Reform: Six Years Later

    Issue Brief

    In 2006, then-Gov. Mitt Romney signed Massachusetts' comprehensive health reform designed to provide near-universal health insurance coverage for state residents. Building on a long history of health reform efforts, the state embarked on an ambitious plan to promote shared individual, employer, and government responsibility. This brief examines Massachusetts' experience with coverage and access to care over the last six years, as well as the state's ongoing efforts to deal with persistent high health-care costs. The…