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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

What Are the Recent Trends in Employer-Based Health Coverage? Employer-sponsored health insurance is the largest source of health coverage for people under 65, but its reach is uneven.

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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  • 2025 Employer Health Benefits Survey

    Report

    This annual survey of employers provides a detailed look at trends in employer-sponsored health coverage, including premiums, worker contributions, cost-sharing provisions, offer rates, and more. This year's report also looks at how employers are approaching coverage of GLP-1 drugs for weight loss, including their concerns about utilization and cost.

  • The Semi-Sad Prospects for Controlling Employer Health Care Costs

    From Drew Altman

    In a commentary on KFF’s 27th employer health benefits survey, President and CEO Dr. Drew Altman discusses the obstacles employers face trying to control their health care costs, and the reasons why they’ve never been meaningful supporters of government cost-containment efforts. He predicts that premium increases expected next year could lead to a new wave of higher deductibles and other forms of cost sharing for the 155 million Americans who rely on employer coverage. Read the column here.

  • What an Income Cap Could Mean for ACA Enrollees and the Federal Budget

    Quick Take

    Some members of Congress are considering an income cap on the ACA enhanced premium tax credits to lower federal costs. Depending on the income cutoff chosen, a cap may have little effect on the federal budget and a big effect on some households’ budgets, particularly for older enrollees.

  • 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.