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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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  • Congressional District Interactive Map: How Much Will ACA Premium Payments Rise if Enhanced Subsidies Expire?

    Issue Brief

    This analysis and interactive map illustrate how much more enrollees in Affordable Care Act (ACA) Marketplace plans would pay in premiums at the congressional district level if the enhanced subsidies were to expire in 2026 as under current law. The tool presents scenarios for an older couple who would lose subsidy eligibility due to their income level and for a single person with a $31,000 income. It also presents net average premium payment increases in each district in states that use Healthcare.gov.

  • Drugs Aren’t the Reason the U.S. Spends So Much on Health Care

    From Drew Altman

    Drew Altman’s column in Axios: the U.S. now spends twice per capita what other wealthy countries do on health care. But while drug costs get all the time in public debate, it's hospital and outpatient spending that mostly explains the difference. And that will be impossible to take on without real pain and political risk, he says.

  • How Prepared is the U.S. to Respond to COVID-19 Relative to Other Countries?

    Issue Brief

    Compared to most similarly large and wealthy countries, the U.S. has fewer practicing physicians per capita but has a similar number of licensed nurses per capita. Looking specifically at the hospital setting, the U.S. has more hospital-based employees per capita than most other comparable countries, but nearly half of these hospital workers are non-clinical staff.

  • Why the U.S. Doesn’t Have More Hospital Beds

    From Drew Altman

    With much of the news focused on the surge capacity of the nation’s hospitals during the COVID-19 pandemic, Drew Altman’s Axios column examines why the nation has a shortage of hospital beds and what can be done about it.

  • How Health Costs Might Change with COVID-19

    Issue Brief

    As the coronavirus spreads rapidly across the United States, private health insurers and government health programs could potentially be burdened with higher health care costs. However, the extent to which costs grow, and how the burden is distributed across payers, programs, individuals, and geography are still very much unknown.

  • How have healthcare prices grown in the U.S. over time?

    Feature

    This chart collection explores price increases in private insurance for common services over time and finds significant geographic variation in prices. For example, the average price of a full knee replacement for those in large employer plans increased from $19,595 in 2003 to $34,063 in 2016, growth of 74% compared to a 28% increase in general inflation. The average price of a knee replacement in New York City is more than twice the price of the same procedure in the Louisville, Kentucky area.