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KFF Health Tracking Poll: Health Care Costs and the Midterms

This KFF poll finds that health care costs continue to top the public’s list of affordability worries, even as concerns about gas prices have risen in recent weeks, with two-thirds of the public expressing worry over affording health care costs. Majorities say health costs will influence their vote this election. Voters favor Democrats on the issue, while Republicans hold an advantage on addressing fraud and abuse.

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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  • Section 10: Plan Funding

    Report

    Exhibit 10.1 Exhibit 10.5 Exhibit 10.2 Exhibit 10.6 Exhibit 10.3 Exhibit 10.7 Exhibit 10.4   10 A self-funded plan is one in which the employer assumes direct responsibility for the costs of enrollees’ medical claims. Employers sponsoring self-funded plans typically contract with a third-party administrator or insurer to provide administrative services for the self-funded plan.

  • Section 9: Prescription Drugs and Mental Health Benefits

    Report

    Exhibit 9.1 Exhibit 9.5 Exhibit 9.2 Exhibit 9.6 Exhibit 9.3 Exhibit 9.7 Exhibit 9.4 Exhibit 9.8 9 There are fewer observations for estimating the average copayment for four-tier drugs compared to other drug types.

  • Section 6: Employee Contributions for Premiums

    Report

    Exhibit 6.1 Exhibit 6.9 Exhibit 6.2 Exhibit 6.10 Exhibit 6.3 Exhibit 6.11 Exhibit 6.4 Exhibit 6.12 Exhibit 6.5 Exhibit 6.13 Exhibit 6.6 Exhibit 6.14 Exhibit 6.7 Exhibit 6.15 Exhibit 6.8  

  • Section 5: Market Shares of Health Plans

    Report

    The distribution of enrollment among types of health plans has remained fairly constant over the past several years. The majority of covered workers are enrolled in PPO plans (55%), followed by HMO plans (25%) (Exhibit 5.1). Although annual changes in plan enrollment have been moderate, enrollment in PPO plans has grown by nine percentage points since 2001. More than half of covered workers (55%) are enrolled in PPO plans, an increase from 46% in 2001…

  • Section 4: Health Insurance Choice

    Report

    Exhibit 4.1 Exhibit 4.6 Exhibit 4.2 Exhibit 4.7 Exhibit 4.3 Exhibit 4.8 Exhibit 4.4 Exhibit 4.9 Exhibit 4.5 Exhibit 4.10 5Survey respondents were asked whether the firm offers a personal or health savings account, including a Health Reimbursement Arrangement (HRA) or other type of health savings account option. 6There are several savings account options permitted under the law, including health reimbursement arrangements, health savings accounts and medical savings accounts. 7Due to the low number of…

  • Update on Individual Health Insurance

    Report

    This report provides information about the individual health insurance market using data from the largest vendor of this type of insurance, eHealthInsurance. The report includes who is buying individual insurance, what they are actually paying for the insurance, and buying patterns. It is the first in an up-coming series of reports jointly produced by the Kaiser Family Foundation and eHealthInsurance to provide trend information in such areas of interest as premiums and cost sharing, and…

  • Section 3: Employee Coverage, Eligibility, and Participation

    Report

    Employers are the principal source of health insurance in the U.S., providing health benefits to about 63% of nonelderly persons in 2002.4 Although the percentage of workers receiving health insurance through their own employer has exhibited only slight annual declines, the cumulative drop since 2001 is over four percentage points. The majority of this decline is among all small firms (3-199 workers). As a consequence, we estimate that there are at least five million fewer…