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Poll: Health Care Costs, Expiring ACA Tax Credits, and the 2026 Midterms

Heading into this midterm election year, the cost of health care tops the public’s economic anxieties, and more than 4 in 10 voters say the issue will have a major impact on their vote, a new KFF Health Tracking poll finds. Two thirds of public say Congress "did the wrong thing" by not extending ACA enhanced tax credits, but Republicans largely say Congress “did the right thing.”

Affordability and Spending

Our Darwinian Approach to Health Care Costs

Our Darwinian Approach to Health Care Costs

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. "...Reducing health care costs has become a Darwinian game; everyone wants to reduce health care costs and spending – their own, often at the expense of someone else."

health system tracker
KEY RESOURCES

  • Health Policy 101: Costs and Affordability

    This Health Policy 101 chapter explores trends in health care costs in the U.S. and the factors that contribute to this spending. It also examines how health care spending varies and the impact on affordability and people's overall financial vulnerability.  


  • Americans’ Challenges with Health Care Costs

    This data note reviews our recent polling data that finds that Americans struggle to afford many aspects of health care, including disproportionate shares of uninsured adults, Black and Hispanic adults and those with lower incomes.

  • National Health Spending Explorer

    This interactive Peterson-KFF Health System Tracker tool allows users to examine five decades worth of data on health expenditures by federal and local governments, private insurers, and individuals.

  • Polling on Prescription Drugs and Their Prices

    This chart collection draws on recent KFF poll findings to provide an in-depth look at the public’s attitudes toward prescription drugs and their prices. Results include Americans’ opinions on drug affordability, pharmaceutical companies, and various potential measures that could lower prices.

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  • 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 Look at Federal Health Data Taken Offline

    Policy Watch

    This post looks at federal government databases with key health data that went offline on Jan. 31, 2025, including several related to HIV, some of which had returned by Feb. 2, 2025. It briefly describing the affected databases, which include widely used, large-scale national health surveys, indices, and data dashboards, that inform research, policy making, and media coverage about health care and public health.

  • How Does U.S. Life Expectancy Compare to Other Countries?

    Feature

    This chart collection examines how life expectancy in the U.S. compares to that of other similarly large and wealthy countries. Between 2019 and 2022, the U.S. experienced a sharper decline and a slower rebound in life expectancy than peer countries, on average, due to increased mortality and premature death rates in the U.S. from the COVID-19 pandemic. In 2023, life expectancy in the U.S. returned to pre-pandemic levels, but remains lower than that of comparable countries.

  • FAQs about the Inflation Reduction Act’s Medicare Drug Price Negotiation Program

    Issue Brief

    The Centers for Medicare & Medicaid Services (CMS) recently announced the drugs selected for the second round of negotiation for the Medicare Drug Price Negotiation Program, which was established by the Inflation Reduction Act. These FAQs address several questions related to Medicare’s drug price negotiation program and CMS's implementation of the program, with a focus on the details that apply for 2027, the second year that negotiated prices will be available under the program.

  • KFF Health Tracking Poll: Public Weighs Health Care Spending and Other Priorities for Incoming Administration

    Feature

    With the incoming Trump administration and Republican-led Congress looking to ways to reduce federal spending, this Poll finds that the Medicare and Medicaid programs remain broadly popular, and more people favor more spending on those programs than less spending. Among potential actions on health, the public sees price transparency and limiting chemicals in food as top priorities. Few say so about cuts to Medicaid and restrictions on abortion.

  • The Semi-Sad State of Consumer Protection In Health Care

    From Drew Altman

    In this column, KFF President and CEO Drew Altman explores the state of consumer protections in health care and explains why, even with consumer frustration clear, Congress is unlikely to pursue major new health insurance protections but there could be some modest steps.

  • How Medicare Negotiated Drug Prices Compare to Other Countries

    Issue Brief

    This analysis finds that Medicare's negotiated prices for 10 high-expenditure prescription drugs are lower than what private Medicare drug plans had been paying, but still much higher than the prices available in 11 other wealthy nations.. It is available on the Peterson-KFF Health System Tracker.

  • Hospital Margins Rebounded in 2023, But Rural Hospitals and Those With High Medicaid Shares Were Struggling More Than Others

    Issue Brief

    This data note examines trends in hospital margins from 2018 through 2023 and how operating margins varied across different types of hospitals in 2023. It shows the industry overall experienced a rebound in 2023 after margins fell sharply the previous year, though some hospitals – particularly those in rural areas and those who see many Medicaid patients – continue to struggle.