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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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  • The Changing Medicaid Managed Care Market

    Report

    Trends in Commercial Plans' Participation This background paper analyzes the trends in commercial plan participation in the Medicaid market by using a database specifically designed for this purpose. It examines changes from mid-1996 to mid-1997 in the types of full-risk plans serving Medicaid Beneficiaries.

  • 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.

  • How Have Costs Associated With Obesity Changed Over Time?

    Issue Brief

    This analysis finds that, among people with large employer health plans, those with an obesity diagnosis on average have higher total and out-of-pocket spending than those without an obesity diagnosis. It also examines the cost of common surgical and pharmacological treatments for obesity.