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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

In 2024, life expectancy in the U.S. reached an all-time high of 79 years but remained years behind the average in comparable countries

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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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 Might Expiring Premium Tax Credits Impact People with HIV?

    Issue Brief

    This issue brief provides an overview of the potential impact not extending enhanced ACA premium tax credits could have on people with HIV and the Ryan White HIV/AIDS Program. Enhanced credits have improved insurance coverage affordability for millions of people, including those with HIV. People with HIV may be particularly vulnerable, given that they are more likely to have Marketplace plans and many also rely on the federally-funded Ryan White HIV/AIDS Program to help cover plan costs. Loss of coverage and increased costs could lead to disruptions in care for people with HIV which could have serious implications for individual and public health.

  • What to Know About How Medicare Pays Physicians

    Issue Brief

    Each year, the Centers for Medicare & Medicaid Services (CMS) updates Medicare payments for physician services and other Part B services through rulemaking. This issue brief answers key questions about how physicians are paid under the Medicare program, and reviews policy options under discussion for payment reform.

  • How Does the Quality of the U.S. Health System Compare to Other Countries?

    Feature

    This chart collection compare health outcomes, quality of care, and access to services between the U.S. and peer countries. While inconsistent and imperfect metrics make it difficult to firmly assess system-wide health quality in the U.S., a review of the available data prior to the onset of the COVID-19 pandemic suggests that in most of these measures, the U.S. has lagged behind comparably large and wealthy countries.

  • KFF Health Tracking Poll: Public Weighs Political Consequences of Health Policy Legislation

    Poll Finding

    KFF's Health Tracking Poll finds that more than three-quarters of the public say they want Congress to extend the ACA enhanced premium tax credits that are set to expire at the end of this year. If the credits do expire and the average premium more than doubles, seven in 10 of those who purchase their own insurance say they would not be able to afford premiums without significantly disrupting their household finances.

  • Health Care Costs and Affordability

    Feature

    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 across the population, the impact of costs on care affordability and individuals' overall financial vulnerability.  

  • Employer-Sponsored Health Insurance 101

    Feature

    This Health Policy 101 chapter explores employer-sponsored health insurance (ESI), the primary health coverage source for non-elderly residents in the U.S. In addition to detailing ESI requirements and incentives, structure, availability, and costs, the chapter examines ongoing challenges related to affordability and access to care for those with ESI coverage.

  • International Comparison of Health Systems

    Feature

    This Health Policy 101 chapter explores the performance of the U.S. health system on a number of cost, outcomes, and quality measures by comparing it with those in similarly large and wealthy OECD nations. It highlights that despite significant spending, Americans have shorter life expectancies and encounter more barriers to health care, influenced by both the health system's structure and broader socioeconomic factors.