Health Costs

In a new Trump administration executive order, the Secretary of HHS is directed to work with Congress to implement a change in law to delay negotiation of so-called “small molecule” drugs under the Inflation Reduction Act’s Medicare Drug Price Negotiation Program for an additional 4 years. This brief analyzes how many of the drugs previously selected for negotiation would not have been eligible if this policy had been in place at the time.

This brief explores data about rural hospitals’ financial health and stability at a time when Congress is considering potential federal budget cuts. It examines the prevalence of rural hospitals, their characteristics and finances, federal support for these facilities, and the potential impact of reductions in Medicaid and Medicare spending that are under consideration.

KFF and the Peterson Center on Healthcare examine market trends contributing to rising health costs and identify several potential federal and state policy issues to watch throughout 2025, including high-cost drugs, federal funding cuts, and workforce shortages.

This brief provides 5 key facts about the role Medicaid plays in delivering care to and financing care for people with HIV.

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 recently passed House budget resolution targets cuts to Medicaid of up to $880 billion or more over a decade to help pay for tax cuts. Major cuts to Medicaid may impact coverage for the almost 1 in 5 Medicare beneficiaries (12.2 million) who are also enrolled in Medicaid.