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Affordability and Spending

Beyond the Data: Are the Tradeoffs from Prior Authorization Worth It? 

In his latest column, President and CEO Dr. Drew Altman asks if prior authorization review could be eliminated entirely, discussing how it might be done and the tradeoffs. He writes “Nothing makes American health care consumers more frustrated using the health system than prior authorization review. I know because they told us that, ranking prior authorization review far ahead of any other problems they have getting care and navigating the health care system, including getting appointments and understanding their bills.”

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 that these 2025 Marketplace enrollees are experiencing following the expiration of the enhanced premium tax credits. The survey 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

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.

 

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 Do Health Expenditures Vary Across the Population? Five percent of the population made up nearly half of all health spendings, pending an average of $72,918 annually in 2023.

NHE explorer

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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  • How Marketplace Costs and Premiums will Change if Rescue Plan Subsidies Expire

    Policy Watch

    In this Policy Watch we explore the potential impact of the expiration of the American Rescue Plan Act’s enhanced financial help and new eligibility for the Affordable Care Act’s health insurance Marketplace federal subsidies. While the COVID-19 relief legislation passed earlier this year provides greater subsidy assistance through 2022, Democrats in Congress are currently considering making the temporary federal help permanent or extending it as part of their planned budget reconciliation legislation.

  • Dental, Hearing, and Vision Costs and Coverage Among Medicare Beneficiaries in Traditional Medicare and Medicare Advantage

    Issue Brief

    This analysis builds on our prior work – Medicare and Dental Coverage: A Closer Look – by analyzing hearing and vision use, out-of-pocket spending and cost-related barriers to care among Medicare beneficiaries as well as hearing and vision benefits in Medicare Advantage plans. It also incorporates top-level findings from the analysis of dental services to provide a comprehensive profile of dental, hearing, and vision benefits in Medicare.

  • Vaccines Are Free. Covid Care Is Not. Who Should Pay?

    Perspective

    In this commentary for Barron's, Cynthia Cox explores the impact to the American public as the U.S. health insurance system adjusts to the COVID-19 pandemic. She uses the experience of the past year and a half to raise questions about broader issues of fairness in the distribution of health care costs in the country.

  • Most private insurers are no longer waiving cost-sharing for COVID-19 treatment

    Issue Brief

    This analysis finds nearly three quarters of the largest health plans in each state are no longer waiving enrollees’ cost-sharing requirements for COVID-19 treatment as of August 2021. Insurers largely waived those costs early in the pandemic, before safe and effetive vaccines were available.

  • Early 2021 Data Show No Rebound in Health Care Utilization

    Issue Brief

    This analysis finds hospital admissions remained below expected levels in early 2021, suggesting much of the care people put off during the early months of the COVID-19 pandemic may have been forgone altogether.

  • The Sleeper Health Cost Policy

    From Drew Altman

    In this Axios column, Drew Altman unpacks President Biden’s recent executive order on promoting competition, exploring its significance for new efforts to control health costs by addressing consolidation in the health care industry.