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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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  • Annual Increase in National Health Expenditures and Their Share of Gross Domestic Product, 1961-2023

    Feature

    Annual Increase in National Health Expenditures and Their Share of Gross Domestic Product, 1961-2023-HEALTHCOSTS Download Source Kaiser Family Foundation calculations using NHE data from Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group, at http://www.cms.hhs.gov/NationalHealthExpendData/ (For 2012 data, see Historical; National Health Expenditures by type of service and source of funds, CY 1960-2012; file nhe2012.zip. For 2013-2023 data, see Projected; NHE Historical and projections, 1965-2023, file nhe65-23.zip). Gross Domestic Product…

  • Paying for Prescribed Drugs in Medicaid: Current Policy and Upcoming Changes

    Issue Brief

    The federal government has proposed new rules that aim to make Medicaid outpatient drug reimbursement policies more closely match the cost of obtaining and filling prescriptions. However, the change in policy may have varying effects on reimbursement, depending on the state’s current approach and the type of drug in question. This paper explains current Medicaid pharmacy reimbursement methodology and examines the potential effect of the proposed rule changes.

  • A Consumer Guide to Handling Disputes with Your Employer or Private Health Plan

    Report

    Most people get their health care through some form of managed care plan – a health maintenance organization, preferred provider organization, or point-of-service option. Most of the time, people receive the care they need, but the potential exists for disagreements over the services that will be provided or paid for by health plans. Health plans are required to follow state and federal rules for handling their enrollee’s complaints and appeals inside the health plan, known…

  • Snapshots: Effect of Tying Eligibility for Health Insurance Subsidies to the Federal Poverty Level

    Issue Brief

    Considerable attention has been paid in recent years to the rapid growth of health insurance premiums and its impact on coverage affordability. Premium growth has far outpaced growth in workers earnings, which means that workers have to spend more of their income each year on health care to maintain current coverage levels. Less attention has been given to the disconnection between the growing cost of health insurance and eligibility for health care subsidies in public…

  • Snapshots: Insurance Premium Cost-Sharing and Coverage Take-up

    Issue Brief

    One of the many reasons an individual may be uninsured is that she or he decides an employer’s offer of health insurance is too expensive. Several studies have noted the likelihood that a worker will decline an employer’s offer of health insurance increases with the amount he or she is required to contribute. Alternatively, employees may obtain coverage through a spouse, opt for publicly provided coverage if eligible, or decide to do without coverage entirely.…

  • Snapshots: Comparing Projected Growth in Health Care Expenditures and the Economy

    Issue Brief

    The rising cost of health care is much in the news. Health costs continue to grow faster than national income and, despite research indicating that we the get good value for the increased spending, some policy makers and health analysts question whether governments and private employers can continue to finance the level of care that they do today. This paper illustrates the magnitude of savings that would be needed in order to bring health care…

  • New Animated Video Provides an Engaging Look at the Cost and Quality of the Nation’s Health System

    News Release

    A new animated video on the Peterson-Kaiser Health System Tracker provides an engaging “check-up” of the nation’s health system, addressing questions of whether it’s getting better or worse and how it compares to other countries. Health of the Healthcare System, produced by the Kaiser Family Foundation, draws on the most up-to-date, reliable data to offer an easy-to-understand portrait of cost, quality and access to health care in the United States. Julie Rovner, a veteran health reporter…

  • Prescription Drugs’ Sizable Share of Health Spending

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman explains why prescription drug spending may be a larger share of health spending than most people think, depending on how you look at it.

  • New Analysis Details Impact on Residents in Different States If the U.S. Supreme Court Rules for Challengers in King v. Burwell

    News Release

    The U.S. Supreme Court is expected to rule this month in the King v. Burwell case that challenges whether low- and moderate-income Americans are eligible for subsidies to help pay for insurance if they live in states where the federal government, rather than the state, established its new insurance marketplace under the Affordable Care Act (ACA). Using 2015 enrollment data released today, a new Kaiser Family Foundation analysis and interactive map breaks out how residents…