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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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  • Why Drug Price Negotiation Has Staying Power

    From Drew Altman

    In this Axios column, Drew Altman looks beyond Medicare to what’s at stake for employers and workers in the debate about the government negotiating drug prices.

  • Election 2024: State Health Care Snapshots

    Feature

    These fact sheets lay out the health care landscape in every state, providing data on a variety of health care topics that may be the focus of policy debates in the 2024 election. Topics include health costs; women’s health policy, including state abortion, contraception and maternity laws and policies; health coverage, including the Affordable Care Act, Medicare and prescription drug coverage, Medicaid, and employer-sponsored insurance; gender affirming care; and basic information on health status, population and income.

  • How Costly Are Common Health Services in the United States?

    Feature

    A new chart collection examines what we know about the cost of common health services in the U.S. The analysis shows that costs for many common health services have risen more rapidly than inflation; for example, the average cost of hospital admission among large employer plans increased by about $10,000 (68%) between 2008 and 2018.

  • FAQs on Medicare Coverage and Costs Related to COVID-19 Testing and Treatment

    Issue Brief

    These FAQs provide the latest guidance on testing and treatment related to COVID-19 for Medicare beneficiaries, including questions related to out-of-pocket costs, the COVID-19 vaccine, telehealth, extended supplies of medication, skilled nursing facility stays, and issues for people in private Medicare Advantage plans.

  • How Much Could Medicare Beneficiaries Pay For a Hospital Stay Related to COVID-19?

    Issue Brief

    As the coronavirus continues to spread, the number of people on Medicare admitted to the hospital for COVID-19 related illness is expected to rise. We analyze how much Medicare beneficiaries could pay out-of-pocket for an inpatient hospital admission under traditional Medicare (assuming no supplemental coverage) or Medicare Advantage plans.

  • Measuring the Affordability of Employer Health Coverage

    Perspective

    A recent draft regulation issued by the Treasury Department describes who is eligible for premium tax credits to help them afford coverage offered through health insurance exchanges beginning in 2014.