Health Costs

Affordability and Spending

Our Darwinian Approach to Health Care Costs

Our Darwinian Approach to Health Care Costs

In his latest column, President and CEO Dr. Drew Altman presents his Venn diagram of health care cost problems and shows how, in our fragmented health system, reducing one health cost problem often makes another worse. "...Reducing health care costs has become a Darwinian game; everyone wants to reduce health care costs and spending – their own, often at the expense of someone else."

Affordable Care Act

An image of text is an excerpt form Jared Ortaliza's quick take which reads, "Data currently being released represent Open Enrollment ACA Marketplace plan selections, or how many people have signed up for or been automatically renewed into 2026 coverage. These data do not necessarily translate to enrollments. That is because people who have selected a plan or been automatically renewed may not ultimately choose to pay for their coverage, thus “effectuating” their enrollment."

ACA Signups Are Down, But Still an Incomplete Picture

Data currently being released represent Open Enrollment ACA Marketplace plan selections, or how many people have signed up for or been automatically renewed into 2026 coverage. These data do not necessarily translate to enrollments. That is because people who have selected a plan or been automatically renewed may not ultimately choose to pay for their coverage, thus “effectuating” their enrollment.

KEY RESOURCES
  • Health Policy 101: Costs and Affordability

    This Health Policy 101 chapter explores trends in health care costs in the U.S. and the factors that contribute to this spending. It also examines how health care spending varies and the impact on affordability and people's overall financial vulnerability.  


  • Americans’ Challenges with Health Care Costs

    This data note reviews our recent polling data that finds that Americans struggle to afford many aspects of health care, including disproportionate shares of uninsured adults, Black and Hispanic adults and those with lower incomes.

  • National Health Spending Explorer

    This interactive Peterson-KFF Health System Tracker tool allows users to examine five decades worth of data on health expenditures by federal and local governments, private insurers, and individuals.

  • Polling on Prescription Drugs and Their Prices

    This chart collection draws on recent KFF poll findings to provide an in-depth look at the public’s attitudes toward prescription drugs and their prices. Results include Americans’ opinions on drug affordability, pharmaceutical companies, and various potential measures that could lower prices.

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  • 5 Key Facts about Medicaid’s Share of National Health Spending

    Issue Brief

    To provide historical context for how changes to Medicaid spending may impact national health spending trends, this brief explores how Medicaid spending contributes to national health spending and how different service areas contribute to Medicaid costs.

  • Health Provisions in the 2025 Federal Budget Reconciliation Law

    Issue Brief

    On July 4, President Trump signed the budget reconciliation bill, previously known as the “One Big Beautiful Bill Act,” into law. This summary provides background, description, budgetary impact and related information on the health care provisions of the law in four categories: Medicaid, the Affordable Care Act, Medicare and Health Savings Accounts (HSAs).

  • How Much and Why ACA Marketplace Premiums Are Going Up in 2026

    Issue Brief

    This analysis of initial rate filings from all 50 states and DC shows ACA Marketplace insurers are proposing a median premium increase of 18% for 2026, more than double last year’s 7% median proposed increase. The analysis includes proposed rate changes by state and insurer.

  • How Much is Health Spending Expected to Grow?

    Feature

    This chart collection explores how health spending is expected to grow in coming years, with a look at growth in prescription drug spending, out-of-pocket spending, and related trends.

  • A Closer Look at the $50 Billion Rural Health Fund in the New Reconciliation Law

    Issue Brief

    The new reconciliation law includes a $50 billion rural health fund. This brief describes the rural health fund, explains what the law says about the allocation of funds, and highlights outstanding questions about how the funds will be distributed across and within states to pay rural hospitals and for other purposes.

  • Implementation Dates for 2025 Budget Reconciliation Law

    Feature

    This searchable timeline shows the implementation dates for the health care provisions included in the 2025 federal budget reconciliation law, previously known as "One Big Beautiful Bill Act." It includes provisions related to Medicaid, the Affordable Care Act, Medicare and Health Savings Accounts (HSAs).