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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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  • Pulling It Together: Implementation Is Forever

    Perspective

    Now that historic health reform legislation is law, everyone is rightfully focused on implementation. There are two very different ways to look at implementation. One is the more legalistic worm's eye view, which sees implementation largely as the process of putting into effect what was written in the law.

  • Section 10: Plan Funding

    Report

    Exhibit 10.1 Exhibit 10.5 Exhibit 10.2 Exhibit 10.6 Exhibit 10.3 Exhibit 10.7 Exhibit 10.4   10 A self-funded plan is one in which the employer assumes direct responsibility for the costs of enrollees’ medical claims. Employers sponsoring self-funded plans typically contract with a third-party administrator or insurer to provide administrative services for the self-funded plan.

  • Recent Tax Proposals to Increase Health Insurance Coverage

    Other Post

    This report includes a side-by-side analysis of recent tax proposals by Members of Congress and various health organizations designed to increase the number of individuals with private health insurance coverage.

  • Medical Care Research and Review

    Other Post

    Journal Supplement This special supplement of includes: original research tracking trends in disparities in health coverage and access to care over two decades; literature syntheses focused on medical treatment and the decision-making process; legal analysis of civil rights laws in the context of managed care; and findings from a national survey of public awareness of…

  • Trends in Overall and Non-COVID-19 Hospital Admissions

    Issue Brief

    This brief shows trends in hospital admissions during the coronavirus pandemic. Admissions to hospitals for reasons other than COVID-19 fell markedly again in November 2020 as cases of infections with the novel coronavirus began to surge anew, suggesting that more people were delaying care due to the worsening pandemic.

  • Limiting Private Insurance Reimbursement to Medicare Rates Would Reduce Health Spending by About $350 Billion in 2021

    Issue Brief

    This analysis estimates the total annual reduction in health care spending by employers and privately insured individuals that would result from having private insurers reimburse hospitals and other health care providers at Medicare rates. In total, we estimate spending for the privately insured population would be an estimated $352 billion lower in 2021 if employers and other insurers reimbursed health care providers at Medicare rates.