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COSTS and Affordability

A Preview of the Role Health Care May Play in the 2026 Election

Ahead of the 2026 midterm elections, this KFF issue brief examines the role health care has played in previous elections and what that may suggest about its potential role in 2026. KFF polls have consistently found that the cost of health care is an important part of voters’ economic concerns.

Affordable care act

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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

In 2024, life expectancy in the U.S. reached an all-time high of 79 years but remained years behind the average in comparable countries

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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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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  • Our Darwinian Approach to Health Care Costs

    Our Darwinian Approach to Health Care Costs

    From Drew Altman

    In his latest column, President and CEO Dr. Drew Altman presents his Venn diagram of health care cost problems and shows how, in our fragmented health system, reducing one health cost problem often makes another worse.

  • Lessons From the Election About Voters and Health

    From Drew Altman

    In this column, KFF president and CEO Drew Altman explores why health costs weigh heavily among voters' economic concerns, even in an election where health was not a flashpoint. The need to reframe health as a pocketbook issue for voters will be central to the competition for the votes of working class Latino voters, two groups very focused on the cost of living.

  • Health Care Experiences of Native Hawaiian or Pacific Islander Adults

    Issue Brief

    A new issue brief based on focus groups conducted by KFF among NHPI adults living in Hawaii and the continental U.S. highlights barriers NHPI people face when accessing health care, including geographic isolation, limited system capacity, and language access. In their own words, participants describe both positive and negative experiences in health care settings and discuss concerns about mental health in their communities.

  • Congressional District Interactive Map: How Much Will ACA Premium Payments Rise if Enhanced Subsidies Expire?

    Issue Brief

    This analysis and interactive map illustrate how much more enrollees in Affordable Care Act (ACA) Marketplace plans would pay in premiums at the congressional district level if the enhanced subsidies were to expire in 2026 as under current law. The tool presents scenarios for an older couple who would lose subsidy eligibility due to their income level and for a single person with a $31,000 income. It also presents net average premium payment increases in each district in states that use Healthcare.gov.

  • A Note on How the War in Iran May Affect Health Care in the Midterms

    From Drew Altman

    In a new column, Dr. Drew Altman, KFF’s President and CEO, discusses the impact of the war in Iran and rising gas prices on voter concerns about health care costs. He writes: “Recently, we saw health care costs rise to the top of the public’s list of economic worries, ahead of food, housing, utility costs and the cost of gas….Expect gas prices to rise and health care costs to fall on the list of affordability worries while the war in Iran lasts, but then to return to the top or near the top when President Trump decides to declare the major hostilities over, the Strait of Hormuz is open, and gas prices come down….health care costs have staying power as one of the top voter concerns.”

  • Drugs Aren’t the Reason the U.S. Spends So Much on Health Care

    From Drew Altman

    Drew Altman’s column in Axios: the U.S. now spends twice per capita what other wealthy countries do on health care. But while drug costs get all the time in public debate, it's hospital and outpatient spending that mostly explains the difference. And that will be impossible to take on without real pain and political risk, he says.

  • How Prepared is the U.S. to Respond to COVID-19 Relative to Other Countries?

    Issue Brief

    Compared to most similarly large and wealthy countries, the U.S. has fewer practicing physicians per capita but has a similar number of licensed nurses per capita. Looking specifically at the hospital setting, the U.S. has more hospital-based employees per capita than most other comparable countries, but nearly half of these hospital workers are non-clinical staff.