Health Costs

This brief focuses on consumers’ understanding of health insurance costs and examines existing federal protections that seek to address barriers to understanding the cost of coverage and care, such as price transparency, self-service price estimator tools, and simplifying cost-sharing designs.

This brief examines a proposed rule that seeks to change how ACA plans would cover gender affirming care services. If finalized the rule could lead insurers to drop coverage or shift costs to individuals and states, making access to gender affirming care more difficult.

In November 2024, CMS finalized a 2.83% decrease in the physician fee schedule conversion factor, a key aspect of payment rates under the Medicare program, resulting in a 2.93% decrease in overall payments to physicians and other clinicians. Congress has not yet enacted legislation to address this payment cut, which went into effect on January 1, 2025. This issue brief answers key questions about how physicians are paid under the Medicare program, and reviews policy options under discussion for payment reform.

The privatization of Medicare has been taking place without much public debate – a trend that has implications for the 68 million people covered by Medicare, health care providers, Medicare spending, and taxpayers. It’s not yet clear whether the administration will promote policies to accelerate the privatization of Medicare or focus more on achieving efficiencies and savings within Medicare Advantage, or pursue policies that aim to achieve both. How this plays out will have implications for beneficiaries, health care providers and insurers, and is worthy of serious debate.

In this JAMA Health Forum post, Executive Vice President Larry Levitt recalls the mid-1990s’ public backlash against Health Maintenance Organizations (commonly known as HMOs) – all of which preceded the recent outpouring of health insurance concerns – as well as how consumer protections against coverage restrictions have evolved and fallen short.

Promoting price transparency in health care is a policy approach with bi-partisan support in Congress and the public at large. This analysis examines the vast troves of price transparency data that payers are required and finds unlikely prices, inconsistencies, and other oddities that pose major challenges for efforts to use it to promote competition and drive down prices.

This analysis presents key facts about hospitals with more than 40 charts related to national spending on hospital care, characteristics of the hospital industry, rural hospitals, use of hospital care, out-of-pocket spending and medical debt, hospital prices, hospital finances, and charity care.

This analysis compares 2021 data about deaths in the U.S. and 11 other large, wealthy countries by age and cause to understand the primary drivers of the longevity gap between the U.S. and the comparable countries. It finds that the primary reasons for the gap in 2021 were chronic disease, COVID-19 and substance use disorders.

KFF’s January 2025 Prescription Drug Advertisements Poll looks at the public’s experiences with prescription drug advertisements, whether they’ve talked to a doctor about advertised drugs, and how this has influenced the care they receive.