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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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  • Medicaid Workers and Job-Based Insurance: Who Is Offered, Eligible, and Enrolled?

    Issue Brief

    Most adult Medicaid enrollees who will be subject to new work requirements are already working but rely on Medicaid because their employers do not offer health coverage or they are not eligible for the coverage offered at their job. This analysis examines the availability of job-based insurance in 2024 for adult Medicaid workers ages 19 to 64.

  • How Do Health Expenditures Vary Across the Population?

    Issue Brief

    This analysis explores the variation in health spending across the population using 2023 Medical Expenditure Panel Survey data. Five percent of the population accounted for nearly half of all health spending in 2023.

  • Constrained Budgets Lead States to Restrict HIV Drug Access Through Ryan White

    Policy Watch

    States are facing constrained budgets, putting pressure on HIV programs, including the Ryan White HIV/AIDS Program. This Policy Watch explores how state Ryan White AIDS Drug Assistance Programs (ADAPs) are responding to these budget pressures, including by restricting eligibility and reducing the scope of services offered, actions that could led to negative health outcomes for people with HIV and lead to new HIV infections.

  • The Midterms Lurk Behind Every Health Policy Move Now

    From Drew Altman

    In his latest column, President and CEO Dr. Drew Altman discusses how midterm political strategy will shape health policy in 2026, focusing on recent moves by President Trump. He writes: “Democrats start out with a significant advantage on health in the midterms, but rather than cut and run to other issues, Trump wants Republicans to try to erode that advantage where they can.”

  • TrumpRx: What’s the Value for Customers?

    Issue Brief

    In February, the Trump administration launched TrumpRx, a government website that provides prescription drug discounts to consumers. This brief examines issues that may impact consumers, especially those with private insurance, who access drug discounts through TrumpRx.

  • What to Know About Pharmacy Benefit Managers (PBMs) and Federal Efforts at Regulation

    Issue Brief

    This brief provides an overview of the role of PBMs in managing pharmacy benefits, discusses federal efforts to reform certain PBM business practices, and explains the estimated federal budgetary impact of the recently enacted legislation, which would be a reduction in the federal deficit of $2.1 billion over 10 years, according to CBO.