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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

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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  • Health Policy 101 Introduction

    Feature

    Health Policy 101 is a comprehensive guide covering fundamental aspects of U.S. health policy and programs, including Medicare, Medicaid, the Affordable Care Act, employer-sponsored insurance, the uninsured population, health care costs and affordability, women's health issues, and health care politics. It includes overviews of private health insurance regulation, racial and ethnic disparities, public health, international comparison of health systems, U.S. global health policy, and the federal role in health policy. The chapters can be downloaded in a PDF format for faculty and student use, and the information will be updated annually or as data and circumstances change.

  • Are Health Insurance Companies the Reason for Our Health System’s Ills? 

    Perspective

    In this JAMA Health Forum column, KFF's Larry Levitt examines the criticism that health insurance companies are facing from political leaders, and explores the industry's role in both causing and addressing some of the health systems' biggest problems, including rising costs and prior authorization review.

  • A One-Pager on What’s Wrong with U.S. Health Care

    From Drew Altman

    Asked for a one-pager on what's wrong with the U.S. health system, Dr. Drew Altman, Founding President and CEO, explains the top issues in this piece, published today as his latest column. Altman explains, "We have neither a competitive health care system nor a regulated one—we have a fragmented, micromanaged health system that fails to control costs and makes both patients and health professionals more miserable than they should be..."