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Affordability and Spending

Beyond the Data: Are the Tradeoffs from Prior Authorization Worth It? 

In his latest column, President and CEO Dr. Drew Altman asks if prior authorization review could be eliminated entirely, discussing how it might be done and the tradeoffs. He writes “Nothing makes American health care consumers more frustrated using the health system than prior authorization review. I know because they told us that, ranking prior authorization review far ahead of any other problems they have getting care and navigating the health care system, including getting appointments and understanding their bills.”

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 that these 2025 Marketplace enrollees are experiencing following the expiration of the enhanced premium tax credits. The survey 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

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.

 

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 Do Health Expenditures Vary Across the Population? Five percent of the population made up nearly half of all health spendings, pending an average of $72,918 annually in 2023.

NHE explorer

National Health Spending Explorer: Get up-to-date information on U.S. health spending by federal and local governments, private companies, and individuals.

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  • Outpatient Visits Are Growing More Complex: Implications for Health Costs

    Issue Brief

    This analysis for the Peterson-KFF Health System Tracker uses claims data from private, large employer-based plan to examine trends in complexity coding across outpatient practice settings from 2004 to 2021. It finds a trend toward higher complexity codes that contributes to higher outpatient spending.

  • How ACA Marketplace Costs Compare to Employer-Sponsored Health Insurance

    Issue Brief

    This analysis compares ACA Marketplace costs to employer-sponsored health insurance costs and finds that individual market premiums have become more similar to employer-sponsored premiums over time. In 2024, individual market insurance premiums averaged $540 per member per month, slightly below the average $587 per member per month premium for fully-insured employer coverage.

  • KFF Health Tracking Poll: Public Weighs in on Health Care Debate and Government Shutdown 

    Poll Finding

    This poll finds that public support remains high for extending the enhanced ACA tax credits set to expire at the end of the year. Three quarters of the public favor of extending them, though support among Republicans has dipped since September. Most Democrats want a Congressional budget deal to include an extension of the tax credits.

  • 2025 California Health Benefits Survey

    Report

    The survey provides an in-depth look at trends in employer-sponsored coverage in California, including premiums, cost sharing, offer rates, and employer strategies to manage costs and access to care, including comparisons to the nation overall.

  • Insurer Rebates under the Medical Loss Ratio: 2012 Estimates

    Report

    Beginning in 2011, the Affordable Care Act (ACA) requires insurance plans to pay out a minimum percentage of premium dollars towards health care expenses and quality improvement activities, limiting the amount spent on administrative and marketing costs and profit.

  • The Alphabet Soup of Care Delivery Transformation

    Event Date:
    Event

    Both the private and public sectors are testing various care delivery transformation models to improve quality, reduce morbidity and mortality, and contain the costs of treatment. The Alliance for Health Reform and WellPoint, Inc. hosted a September 10 briefing to discuss delivery system innovations, Medicare care coordination, and low-spending health care practices.