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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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  • How Many Medicare Part D Enrollees Had High Out-of-Pocket Drug Costs in 2017?

    Issue Brief

    The Medicare Part D prescription drug benefit has helped improve the affordability of medications for people with Medicare. Yet Part D enrollees can face relatively high out-of-pocket costs because the Part D benefit does not have a hard cap on out-of-pocket spending. This analysis presents the latest data on out-of-pocket drug spending among Medicare Part D enrollees without low-income subsidies who have costs above the catastrophic coverage threshold.

  • The Only Health Care Prices That Matter to Consumers

    From Drew Altman

    In this column, Drew Altman zeroes in on a key test for when the implementing rules are written for the new executive order on hospital price transparency: consumers will need to know what amount they must pay out of pocket to really help them shop on price.

  • Uwe Reinhardt - Event - Page

    Uwe Reinhardt’s New Book Priced Out: His Health Policy Ideas in Today’s Debates

    Event Date:
    Event

    Dr. Uwe Reinhardt is a giant in the health policy field who advised policymakers and influenced debates about the nation’s health system before his passing in 2017. His recently released last book, Priced Out: The Ethics and Economics of Health Care, completed by his wife and longtime collaborator Tsung-Mei (May) Cheng gives us the gift of further insights into the U.S. health system and many issues that the country is debating right now, ranging from health price…

  • Analysis: ‘Cadillac Tax’ on High-Cost Health Plans Could Affect 1 in 5 Employers in 2022

    News Release

    A new KFF analysis estimates that the Affordable Care Act’s tax on high-cost health plans would affect one in five (21%) employers offering health benefits when it takes effect in 2022 unless employers change their health plans. An even larger share (31%) could be affected when workers’ voluntary contributions to Flexible Spending Accounts are taken into account. The analysis comes as some in Congress are proposing to repeal the ACA’s tax on high-cost health plans,…

  • Medicare Part D Enrollees with Serious Health Conditions Can Face Thousands of Dollars in Out-of-Pocket Costs Annually for Specialty Drugs

    News Release

    Despite Medicare’s protections, Part D enrollees with serious health conditions can face thousands of dollars in annual out-of-pocket costs for expensive specialty drugs, a new KFF anaylsis finds. The analysis draws on data from Medicare’s Plan Finder website to calculate expected annual 2019 costs for more than two dozen specialty tier drugs used to treat four health conditions -- cancer, hepatitis C, multiple sclerosis and rheumatoid arthritis – based on coverage and costs in national and…

  • Low- and moderate-income people are less likely to have employer-sponsored health insurance.

    What Are the Recent Trends in Employer-Based Health Coverage?

    Issue Brief

    Employer-sponsored health insurance is the largest source of health coverage for people under 65, covering 165.6 million people in March 2025. This analysis examines who among people under 65 have employer coverage and which workers are offered and eligible for coverage at their jobs, using the Annual Economic and Social (March) Supplements of the Current Population Survey.

  • Some Can Get Marketplace Plans With No Premiums,Though With Higher Deductibles and Cost-Sharing

    News Release

    Many low-income consumers who are eligible for federal financial help under the Affordable Care Act can get a bronze-level plan and pay nothing out-of-pocket in premiums in more than 2,000 counties next year, depending on their annual income, according to a new analysis from KFF (the Kaiser Family Foundation). Such plans come with higher deductibles and out-of-pocket maximums, however. The analysis finds that the ACA’s premium tax credits would cover the full premium of the lowest-cost bronze…

  • A Generation of Health Care in the United States: Has Value Improved in the Last 25 Years?

    Issue Brief

    Using data from the Health System Dashboard, a new analysis looks at trends in health spending and outcomes in the United States between 1991 and 2016. While many U.S. health outcomes, like life expectancy and disease burden, have improved, the share of GDP devoted to health increased by 40%, and the U.S. still lags behind other countries in many key measures. The analysis is part of the Peterson-Kaiser Health System Tracker, an online information hub dedicated to monitoring and…

  • How Much Does Medicare Spend on Insulin?

    Issue Brief

    The price of insulin, used by people with both Type 1 and Type 2 diabetes to control blood glucose levels, has come under increasing scrutiny as policymakers grapple with rising drug costs. This data note finds spending on insulin by Medicare and beneficiaries enrolled in private Part D drug plans has increased sharply between 2007 and 2017.