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Food Safety Finds a Place Among ‘Kitchen-Table’ Political Issues
Recent outbreaks of foodborne illness and high-profile recalls have made this issue a concern of voters.
Jefferson County begins local public health survey
Jefferson County health officials will conduct door-to-door surveys in Birmingham and surrounding communities.
Proposed Changes to Demographic Data Collection in the Census Could Impact Efforts to Address Health and Health Care Disparities
This issue brief provides an overview of the decennial census and discusses potential implications of the changes outlined in a September 2026 proposed rule to prohibit the collection of race and ethnicity data on the census and exclude many noncitizen immigrants from the apportionment count.
Paid Family and Sick Leave in the U.S.
This fact sheet summarizes federal, state, and local policies on paid family and medical leave and paid sick leave.
As Health Insurance Costs Soar, Healthcare Workers Also Feel The Pinch
By Hayat Norimine and KFF Health News HealthDay ReportersFRIDAY, Sept. 25, 2026 (HealthDay News) — Joshua and Ashley Durham run a family medicine practice, and for the first time in their lives, they have no health insurance. When the Durhams began their practice in Boise, Idaho, at the end of 2023 ...
Medicare Beneficiaries with Multiple and Complex Health Needs Face Challenges
New KFF polling focuses on the health care access and affordability challenges among adults with multiple or complex health conditions, including older Medicare beneficiaries. The results suggest important opportunities for policymakers to strengthen Medicare access and affordability. Medicare Beneficiaries Often Have High Health Needs Many Medicare enrollees have multiple or serious health conditions. More than […]
Health Insurance Coverage of the Urban Population
State level data on Health Insurance Coverage of the Urban Population from KFF, the leading health policy organization in the U.S.
KFF Women’s Health Survey Explores How Women Navigate Contraceptive Information
Many reproductive-age women seek health information through online sources, where they may encounter false or misleading information about contraception, according to the 2026 KFF Women’s Health Survey. And an Ohio health department’s new AI policy offers a rare example of a health-specific policy addressing accuracy and public trust.
Black Lung Disease Remains a Threat, but Federal Officials Delay Effort To Address It
The disease has long been a risk of coal mining, an industry the Trump administration is trying to reinvigorate.
As health insurance costs soar, healthcare workers feel the pinch
Nationwide, 7% of all healthcare workers were uninsured in 2024, compared with 11% of all adults under 65, according to a KFF analysis.
Women's Health Care Affordability Challenges
As health care costs dominate the national political conversation, our 2026 KFF Women’s Health Survey shows the toll those costs are taking on women. Our new nationally representative survey of women and men ages 18–64 finds costs remain a major barrier for women, specifically — causing everything from delayed care to rationed medications to cuts in spending on basic needs.
As health insurance costs soar, some Idaho healthcare workers pay for medical care out of pocket
This story was first published by KFF Health News on Sept. 22, 2026. Joshua and Ashley Durham run a family medicine practice, and for the first time in their lives, they have no health insurance. When the Durhams began their practice at the end of 2023 — he as a primary care physician and she […]
Economic Frustration Tests Trump’s Standing With Rural Voters, New KFF-AP Poll Finds
Rural voters rank the cost of living and cost of healthcare as top issues they want to hear about from midterm candidates as they face a tightening pocketbook pinch.
KFF/AP Survey Probes Rural Voters’ Increasing Anxieties About the Rising Cost of Living, Including Health Costs, Heading into the Midterm Elections
Rural voters’ frustrations about the cost of living in their community are growing and appear to be chipping away at Republicans’ enthusiasm to vote as the midterm elections near, a new KFF/AP Survey of Rural Voters finds.
What CDC's new teen health survey shows, and what it skips
Teen suicide risk hit a 10-year low in 2025. Guns, sexual violence, and self-harm. Where are the 2025 data on transgender teens? Missing data changes public health policy. Teen suicide risk hit a 10-year low in 2025. CDC asked more than 10,000 high school students over 100 questions in spring 2025. Yesterday, it published a report covering a fraction of them. The report focsed on five areas: diet, physical activity, sleep, digital behaviors, and mental health, reflecting the priorities of the Make America Healthy Again movement. There was good news. Fewer teens seriously considered suicide in 2025 than in any survey year since 2015: 14%, down from 20% in 2023. Sadness fell. Underlying Conditions is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Subscribe Sports participation, which dipped to 49% in 2021, is back to its 2015 level of 58%. Daily PE fell from 27% to 20% in two years, while fewer students eat breakfast daily than a decade ago. Guns, sexual violence, and self-harm. The questionnaire is public, and it goes well beyond those five areas. Students answered questions about sexual violence, self-harm, and whether they got help when they felt sad or anxious. They said how quickly they could get a loaded gun. They reported whether food ran out at home and whether they felt close to people at school. There were questions about sexual identity, including whether they were transgender. The report did not publish any of the answers students gave to those questions. CDC posts the raw survey data online, so anyone can see what the report left out. The report doesn’t cover the health of sexual minority students. Among students who identified as gay, lesbian, bisexual, questioning, or another non-straight identity, persistent sadness fell from 66% to 57% between 2023 and 2025. Serious thoughts of suicide fell from 41% to 30%. Those drops were bigger than the ones among straight students, although the gap remains wide: 28% of straight students reported persistent sadness, about half the rate of LGBQ+ students. About 1 in 7 girls reported sexual violence in the past year. One in 6 students hurt themselves on purpose. Among students who needed help for sadness or anxiety, half rarely or never got it. And among students who had seriously considered suicide, 43% said they could get a loaded gun without an adult’s permission. One protective factor rose sharply. In 2023, 55% of students said they felt close to people at their school; in 2025, 63% did. CDC’s earlier research ties that kind of connection to better mental health. Where are the 2025 data on transgender teens? In 2023, CDC's national survey asked high school students, for the first time, whether they were transgender. Their answers are the only nationally representative data on transgender teens, and their mental health is by far the worst of any demographic. That year, 71% of transgender students reported persistent sadness, 54% seriously considered suicide, and 26% attempted it, compared with 38%, 18%, and 8% of cisgender students. But we don’t have 2025 data. The timing matters because students took the survey in spring 2025, as federal policy toward transgender youth shifted. On January 28th, an executive order directed agencies to end federal support for gender-affirming care for people under 19, and several hospitals paused that care within days. In February, the CDC said it would no longer process transgender identity data. Later in 2025, the Supreme Court upheld Tennessee’s ban on gender-affirming care for minors, and HHS ended the 988 Lifeline’s dedicated line for LGBTQ+ youth. Researchers disagree about how much state policy shapes trans teens’ mental health. A 2024 Trevor Project study estimated that anti-trans laws increased suicide attempts among trans and nonbinary youth. Critics dispute its methods and its estimates. The 2025 survey could have added national evidence to that fight. CDC collected the data but hasn’t publicly released it. Missing data changes public health policy. Surveillance works as a feedback loop. It can show officials whether their policies help or hurt. The CDC didn’t provide data on the students most exposed to transgender policy shifts. The report kept measures that frame health as personal choice, like fruit, breakfast, and sports. It left out measures that track policy, like gun access, mental healthcare, food at home, and school climate, all of which respond to what legislators and agencies decide. HHS did not respond to questions that I sent on September 21st.
Insurance Coverage Lags as Cancer Science, Treatment Move Forward
“Brain cancer” or “H4 G34-mutant”? As knowledge about genetics advances, some doctors say cancers should be defined by their mutations, not the tissues where they manifest.
Insurance Coverage Lags as Cancer Science, Treatment Move Forward
“Brain cancer” or “H4 G34-mutant”? As knowledge about genetics advances, some doctors say cancers should be defined by their mutations, not the tissues where they manifest.
Implementation of 2025 Reconciliation Law: Medicaid Managed Care Rate Setting Uncertainty & Potential Plan Exits
This policy watch examines recent and anticipated managed care rate setting challenges and the potential implications of MCO exits.
It’s Hard To Predict Who Will Be Suicidal. It’s Easier To Ensure People Can’t Shoot Themselves.
Some mental health experts favor suicide prevention steps that are applied broadly, with protections that aren’t tied to an individual’s specific risk.
Health Journalists Visit Conservative Georgia District and Weigh AI Bioweapon Threat
KFF Health News journalists made the rounds on national and local media recently to discuss topical stories. Here’s a collection of their appearances.
A Closer Look at the $50 Billion Rural Health Transformation Program
The 2025 budget reconciliation created the Rural Health Transformation Program, which will award $50 billion in state grants over a five-year period. This brief provides an overview of the program, describing its structure, how funds can be used, how funding compares to Medicaid spending reductions in the reconciliation law, and how the funds are being distributed across and within states.
States Bet Big On Rural Health Startups, With A Silicon Valley Twist
By Sarah Jane Tribble and KFF Health News HealthDay ReportersFRIDAY, Sept. 18, 2026 (HealthDay News) — When Josh Fleig, Louisiana’s chief innovation officer, learned his state had set aside $20 million a year, for five years, to invest in startup rural health companies, his reaction was not ...
Sticker Shock at the Doctor's Office Could Motivate Midterm Voters
Steep jumps in health insurance premiums and deductibles are top of mind for many voters heading into midterm elections. KFF Health News chief Washington correspondent Julie Rovner explains how rising costs may shape competitive races. She also distills plans from candidates on both sides of the aisle to bring costs down.
Cost-Saving Medicaid Meal Deliveries Threatened by Cuts, Policy Uncertainty
An experiment to provide meals to some Medicaid recipients shows food can be cost-effective medicine. But even as federal officials tout the power of nutrition, Medicaid budget cuts could lead states to think twice about covering healthy food for sick residents. One has already reconsidered.
ACA health coverage enrollment in NH declined by 4.8k after credits expired
The KFF analysis found that New Hampshire enrollment in ACA healthcare plans fell by 8 percent from 2025 to 2026. Across the country, enrollment fell from roughly 21.8 million in 2025 to 19.2 million in 2026, per KFF.
ACA health coverage enrollment in NH declined by an estimated 4.8K after tax credits expired
After a set of tax credits designed to help Americans afford healthcare expired, 4,868 fewer New Hampshire residents were enrolled in ACA Marketplace healthcare plans, according to an analysis of federal data by KFF.
California Eyes Prison Heat Protections That Fall Short of Workplace Standards
California is crafting weaker heat protections for prisons than other workplaces, citing billions in costs to cool aging institutions as climate and health risks increase. It’s a second-class standard, health and safety advocates say, and would leave correctional workers more susceptible to heat illness.
3 Common Drugs Older Adults Might Be Overusing
Not all older people need benzodiazepines, antibiotics, or daily aspirin — and taking them can carry increased risks.
Healthcare affordability is shaping competitive races ahead of the midterm elections
Healthcare costs are rising at their fastest pace in decades, just as early voting begins in Virginia. KFF Health News' Julie Rovner says the moment echoes the run-up to the Affordable Care Act — and voters are taking notice.
States Bet Big on Rural Health Startups, With a Silicon Valley Twist
States are spending rural health dollars on tech startups, betting that untested companies will succeed where doctors have vanished and hospitals have collapsed. Louisiana’s call for innovative technology drew more than 200 pitches, seeking from $250,000 to $3 million in seed money.
Health Care Access and Affordability for Adults with Multiple or Complex Health Conditions: A Snapshot of Patient Experiences
KFF polling has long shown that many U.S. families struggle to afford health care and how costs shape decisions about whether and when to seek care. In the past year, worries about costs have intensified, with the cost of health care topping the public’s list of economic anxieties. Even adults with health insurance report difficulty...
Survey: Adults With Multiple or Complex Health Conditions Face Significant Challenges with Health Costs and Commonly Struggle to Access Care
Adults with multiple or complex health conditions, who already face unique physical and mental challenges, commonly struggle to pay their medical bills and access needed care and medication—challenges that fall hardest on uninsured adults, according to a KFF survey of more than 25 thousand adults. “If the first obligation of a health care system is to take care of the sick, we are failing that test. Cost and access problems are hitting the chronically ill hard, and the chronically ill and uninsured especially hard,” said Dr. Drew Altman about the survey’s findings.
Health Care Access and Affordability for Adults with Multiple or Complex Health Conditions: A Snapshot of Patient Experiences
Significant shares of adults with multiple or complex health conditions, including cancer, lung disease, diabetes, cardiovascular disease, and mental health conditions say they struggle to pay their medical bills and access needed care and medication. These challenges fall hardest on uninsured adults who face greater costs and access challenges.
Correcting False Health Claims and Navigating AI-Generated Information
Corrections can improve the accuracy of people’s beliefs, but their impact may depend on reaching people before a claim has already spread widely. And research on AI-generated search results suggests that people may be less likely to visit the original sources behind AI-generated answers.
A Generation of Kids Suffer as Trump Destabilizes Immigrant Families
Children in immigrant families are facing health threats from President Donald Trump’s policies: separation from parents detained or deported by Immigration and Customs Enforcement, economic and housing instability, withdrawal from health and nutrition programs, and an overarching environment of fear.
Up, up, and away: Are double-digit health insurance rate increases ahead?
Twelve Affordable Care Act participating insurers submitted for rate increases in the coming year, data published by KFF show.
Up, up, and away: Are double-digit health insurance rate increases ahead?
It looks like another round of health insurance premium increases for millions of Floridians who get their insurance through the federal health care makretplaces. Twelve Affordable Care Act participating insurers submitted for rate increases in the coming year, data published by KFF show. AmeriHealth Caritas Florida filed for the largest increase, 39.14%. By contrast, Centene […]
Anger Over Health Costs Clouds Midterms
Amid a campaign already focusing on affordability, anxious voters are unlikely to be assuaged by headlines about healthcare costs rising even more next year. And a lawsuit that could cut off access nationwide to the abortion pill mifepristone gets a hearing in federal court. Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine, Sandhya Raman of Bloomberg Law, and Amanda Seitz of KFF Health News join KFF Health News’ Julie Rovner to discuss these stories and more. Also this week, Rovner also interviews Lauren Sausser, who wrote the latest KFF Health News “Bill of the Month.”
Health insurance premiums estimated to increase upwards of 10%, analyses say
Health insurance premiums in Ohio are expected to increase by about 10.7%, according to an analysis from Healthinsurance.org based on health premiums in the individual market. Affordable Care Act Marketplace insurers are proposing a median premium increase of 15% in 2027, according to an analysis of insurers with publicly available filings by KFF, a nonprofit health policy research, polling, and news organization.
Health insurance premiums estimated to increased upwards of 10%, analyses say
Health insurance premiums in Ohio are expected to increase by about 10.7%, according to an analysis from Healthinsurance.org based on health premiums in the individual market. Affordable Care Act Marketplace insurers are proposing a median premium increase of 15% in 2027, according to an analysis of insurers with publicly available filings by KFF, a nonprofit health policy research, polling, and news organization.
When a Friend Becomes a Caregiver
People outside the family frequently step into helping roles when older adults need assistance.
Healthy Aging - What’s Normal, What’s Not & Simple Ways to Stay on Top of Your Health
As we get older, our health needs often become more complex. Staying proactive can help but knowing where to start can be confusing. What should older adults focus on to keep their bodies and minds healthy?
The Market Forces Quietly Adding Thousands To Patient Bills
By Elisabeth Rosenthal and KFF Health News HealthDay ReportersWEDNESDAY, Sept. 9, 2026 (HealthDay News) — After a failed round of in vitro fertilization this year, Anne Hug’s fertility doctor said she had a single polyp in her uterus that should be removed to improve the chance of pregnancy. Hug, a ...
Nonprofits Are Helping Musicians Pay for Insurance in Austin, Texas, and Beyond
A nonprofit and a local public health agency are subsidizing marketplace health insurance for Austin music artists, even as shifting marketplace conditions make the program a more expensive proposition. It’s becoming a model for other cities and sectors.
A NY Hospital Tried To Close Its Birthing Center. This City United To Fight Back.
The people of Troy, New York, united to challenge a national Catholic health system determined to close the last birthing center in the county.
Mapping the Global Health Landscape: Analysis of Fourteen International Organizations
The global health architecture includes a number of diverse international organizations with different mandates, governance models, financing structures, and operational approaches. This KFF resource looks across a range of variables to provide a descriptive mapping of 14 key global health and related international institutions. It is intended to inform discussions about synergies and coordination, duplication, comparative advantage, shared challenges, and architectural reform.
Democrats Demand Trump Administration Halt Collection of Patients' ER Records
Senate and House Democrats say the Trump administration’s plan to collect patients’ medical data violates privacy and will discourage people from seeking medical care.
‘It’s Triage’: California’s Next Governor Will Face Destabilizing Surge in Uninsured
The nation’s uninsured rate hit a historical low when Xavier Becerra was health secretary. Now he wants to be California’s next governor as states stare down the biggest rise in the uninsured rate in a generation.
The Market Forces Quietly Adding Thousands to Patient Bills
The true cost of “vertical integration”: patients directed to a higher-priced location for procedures. Or forced to buy from their insurer’s wholly owned pharmacy, which may not stock the drug prescribed or provide it at the lowest price.
$50B Rural Health Transformation Program Needs More Transparency, Groups Say
By Arielle Zionts and KFF Health News HealthDay ReportersTHURSDAY, Sept. 3, 2026 (HealthDay News) — One year into its creation, a $50 billion federal program aimed at improving rural healthcare lacks transparency, which could make it difficult to protect against fraud, identify successful projects ...
KFF’s ‘Bill of the Month’ highlights $1,200 out-of-pocket charge for a breast MRI
The news site first launched the crowdsourced investigations back in 2018, seeking to dissect and better explain medical bills to consumers.
LGBTQ+ adults more likely to miss or forgo healthcare, survey finds
LGBTQ+ adults are more likely than other adults to miss healthcare appointments due to cost or other reasons — with a third reporting their health worsened as a result, according to a new survey by health policy research group, KFF. Among the 2,640 LGBTQ+ adults surveyed, those who are transgender, younger than 30, those with lower incomes or without insurance were most likely to miss or forgo care due to cost.
High Fertility Costs Push Americans Abroad For IVF Treatment
By LJ Dawson and KFF Health News HealthDay ReportersMONDAY, Aug. 31, 2026 (HealthDay News) — In the summer of 2024, Emilie and Justin Solomon found themselves on a top-secret mission in Greece. Their family and friends thought the adventure-loving couple was on another jet-setting vacation, but they ...
Ray Winstone recalls defending costar groped by director: ‘It was dealt with’
Ray Winstone says he once spoke up for a costar on the set of a film after the director assaulted her. ‘He abused his power, took advantage, and she was a good kid,’ Winstone recalled. ‘Anyway, it was dealt with.’
Summer’s health policy themes
As summer comes to a close, some of the season’s major health policy stories continue to simmer, including declining insurance coverage, increasing
Examining LGBTQ+ Adults’ Experiences with Health Care Costs and Access
This report examines how LGBTQ+ adults' experiences with health care costs and access compare to those of non-LGBTQ+ adults, finding that LGBTQ+ adults face significantly greater challenges affording and accessing care.
Different State Regulatory Approaches Reflect Open Questions About AI Mental Health Tools
States are taking different regulatory approaches to AI mental health tools in response to concerns about chatbots providing inaccurate or potentially dangerous advice. Laws and pending legislation in some states restrict AI from providing or advertising itself as therapy, while others focus on data protections, disclosures, and patient consent requirements.
$50B Rural Health Transformation Program Needs More Transparency, Groups Say
States must submit Rural Health Transformation Program progress reports to the federal government, but they aren’t required to proactively post those reports, or related information, publicly.
Rural health grants aimed at offsetting Medicaid cuts go to 80 unique institutions
According to a brief from KFF, the fund could offset 37% of the estimated federal Medicaid spending cuts in rural areas.
Her Breast MRI Was Approved, But That Didn’t Mean Her Insurance Would Pay
Stephanie Halver’s doctor recommended she get a breast MRI, partly because of her family’s cancer history. Her insurer approved the scan, but unlike mammograms, breast MRIs aren’t universally covered as zero-cost preventive care.
Ebola Is Still Killing In Central Africa. These Groups Are Working To Save Lives
By Rachel Spears and KFF Health News HealthDay ReportersTUESDAY, Aug. 25, 2026 (HealthDay News) — Misinformation and distrust are among the challenges facing public health workers in the Democratic Republic of Congo as they confront the second-deadliest Ebola outbreak on record. Even though the ...
7 science-backed things to do on your phone for better brain health
Scrolling mindlessly can worsen your mood. Try this instead.
Patients wary of governments, companies pushing AI as a rural healthcare solution
Two of the nation’s most powerful health officials predict artificial intelligence will play a key role in solving rural America’s health challenges.
Kennedy Promised 'Radical Transparency' and 'Gold-Standard Science.' Trump's Vaccine Order Promotes Neither.
Get our weekly newsletter, The Week in Brief, featuring a roundup of our original coverage, Fridays at 2 p.m. ET.
Watch: Mark Cuban Says You Can’t Fix Healthcare Until Every Price Is Known
With his online pharmacy, Mark Cuban changed how generic drugs are sold — and he has thoughts about how to fix the healthcare system. The billionaire businessman talks to KFF Health News’ Julie Rovner to answer the question: “How Would You Fix It?”
Violence Against Healthcare Workers and Staffing Shortages Fuel Hospital Strikes
Healthcare workers at a Michigan hospital have been on strike since last September. Violence on the job is one reason behind it, with federal data showing hospital workers are seven times as likely to be injured on the job due to violent acts as members of the general working population.
Newsom Promotes Affordable Insulin, But California's Generic Label Off To A Slow Start
By Angela Hart and KFF Health News HealthDay ReportersTUESDAY, Aug. 18, 2026 (HealthDay News) — At a Walgreens in San Francisco’s bustling Japantown neighborhood, pharmacist Margaret On stocks two boxes of long-acting insulin pens from California’s new prescription drug label, CalRx, emblazoned ...
Trump Team’s Use of Arcane Budget Rule Threatens Medicaid Coverage
Coverage for hundreds of thousands of Arkansas Medicaid enrollees next year is in question after the Trump administration refused to renew a key state waiver. The state might not be the last to have to adjust to an arcane rule change under the One Big Beautiful Bill Act.
Hospitals Say They Found a Tool To Help Reduce Childbirth Risks: Wristbands
North Carolina and other states have embraced “I Gave Birth” wristbands as a way to encourage women to seek help when they have postpartum complications. They’re gaining steam as the Trump administration’s cuts to Medicaid threaten postpartum care.
The U.S. Healthcare System is Already Mostly Socialized
Now that Abdul El-Sayed is the Democratic nominee for Michigan’s open Senate seat, the outcome of this crucial race will depend mainly on two things: Whether Republicans succeed in demonizing El-Sayed because he’s brown and a Muslim, and whether they succeed in demonizing him as a left-wing radical. I will defer for the now the question of whether bigotry will be effective this year, although I will address it another day. What I want to address instead is El-Sayed’s signature issue — healthcare. Yes, El-Sayed advocates Medicare for All, a position the usual suspects denounce as “socialism.” I will get to the politics of his stance soon. Today, however, I want to talk about the substance. We should be clear that El-Sayed doesn’t even call himself a socialist. On the contrary, he explicitly disavows the label, saying “I’m a capitalist who just knows about capitalism”. In fact, as I explained in a previous post, the policies that El-Sayed advocates qualify him as a social democrat, not a socialist. Still, El-Sayed advocates a system under which the government would pay almost all medical expenses. Isn’t that socialism? Well, if that is the criterion then much of U.S. healthcare is already socialist. In fact, the government’s role is so large that U.S. healthcare is better described as partially privatized socialism than as anything resembling a free market. Let’s start with the raw numbers on health insurance, which pays the bulk of Americans’ medical expenses. Americans receive health insurance either from private companies or from public programs, overwhelmingly Medicare and Medicaid. Here’s what the breakdown of coverage and spending between private and public looked like in 2024: While a majority of Americans with health insurance get it from private companies, well over 100 million of us are covered by government programs instead. And these government programs pay more total dollars for medical bills than the private insurers do. Why do government programs that cover a minority of the population account for a majority of health insurers’ outlays? Mainly because Medicare covers seniors, and we’re expensive. Also, while Medicaid covers many younger Americans, disabled and elderly beneficiaries account for most of its spending. Even by the raw numbers, then, U.S. health insurance looks as much public as private. But that understates the government’s role: Private health insurance in the U.S. is both highly regulated and heavily subsidized. This is obviously true for the insurance coverage purchased by tens of millions of Americans through the exchanges established by the Affordable Care Act. But employment-based health insurance, which covers 161 million Americans, is far more of a government creation than most people realize. For employment-based insurance exists largely because of huge implicit government subsidies that come with major strings attached. Here’s how that works. If your employer pays you $10,000, that’s taxable income. But if your employer pays $10,000 toward a company health insurance plan that meets certain criteria, it isn’t taxable. That’s a huge effective subsidy, running at more than $300 billion a year. Take that subsidy into account, along with the more than $100 billion per year spent subsidizing policies purchased under the ACA, as well as the outlays on Medicare and Medicaid, and net effect is that the government pays for more than two-thirds of Americans’ health insurance. Granted, there are strings attached. Roughly speaking, employment-based health plans can’t discriminate based on medical history — that is, they can’t deny coverage to employees with pre-existing conditions — and they also can’t offer the plans only to highly compensated employees — a health plan that is only for the C-suite is considered taxable income. So given the restrictions of the federal tax code, employer-based health insurance is a lot like Obamacare, which also prohibits discrimination based on medical history and provides subsidies to make insurance affordable to lower-paid workers. The fact is that virtually all of private healthcare insurance is already well under some form of government control through regulation and tax subsidies. How should we think about this system? First of all, is Medicare socialist? Don’t tell anyone, but the way Medicare operates — it covers every senior’s medical expenses, whatever they turn out to be, while being funded by taxes that depend on one’s income — could be summarized by the old Marxist slogan “From each according to his ability, to each according to his need.” And back in 1961, when Ronald Reagan was the face of a last-ditch effort by the American Medical Association to block the creation of Medicare, he denounced Medicare as “socialized medicine” and warned that it would destroy our freedom. In reality, American freedom survived until Jan. 20, 2025, while Medicare is immensely popular, with an 82 percent favorable rating in the most recent KFF survey. Medicaid, government health insurance for lower-income Americans, comes in at 73 percent. This is in sharp contrast to public views about private insurers, who are widely disliked if not hated and accused of denying essential care. Furthermore, if Medicare is socialism, then the whole U.S. health insurance system, with the government paying most of the bills and placing conditions on private insurers, is almost equally socialist. If you insist on calling any program the government pays for and regulates socialist, then U.S. healthcare would best be described as a partially privatized form of socialism. And one must ask, what is the point of the part that is privatized? Do private insurers add anything positive? Or are they simply parasites, skimming off money that could have been paying for care? The case for viewing insurers as parasites is strong. Many Medicare benefits are now delivered via Medicare Advantage, that is, plans paid for by the government but run through insurance companies. MedPAC, an independent advisory commission, estimates that last year Medicare Advantage plans were overpaid by $84 billion, thanks to practices such as “upcoding,” in which patients’ health problems are overstated to get larger sums from Medicare. Assessing the waste from employer-based insurance is harder, but most evidence suggests that private insurers have substantially higher administrative costs than Medicare does. Furthermore, the complexity of private insurance, with multiple payers all trying to deny care when they can, is a huge burden both on providers — doctors, nurses, and hospitals — and on patients. What do private insurers offer to compensate for these costs? One must go through intellectual contortions to avoid the conclusion that they are, in fact, parasites. Which brings me back to El-Sayed. In supporting Medicare for All, he’s basically calling for an end to the partial, parasitic privatization of a healthcare system that is already hugely dependent on public funding. When one looks at it that way, it’s not at all a radical proposal. Admittedly, the political lift requires overcoming the opposition to higher taxes to pay for Medicare for All. Political realism rather than economics was the reason I and many other progressives supported Obamacare, with all its complexities, rather than demanding an immediate move to Medicare for All. But the political calculus may very well have shifted since the 2000s, as Americans are fed up with a system of unaffordable premiums, rampant claim denials, and byzantine claim administration. Moreover, funding healthcare insurance through taxation would allow for a much more progressive distribution of the cost. That is, compared to the present system, middle-income households would pay less as high-income households would pay more. And the U.S. would stop wasting large sums on pointless administrative costs. So let’s be clear: El-Sayed’s healthcare platform is perfectly reasonable on the merits of cost, fairness and health efficacy. And with private insurers never more hated, while millions of Americans are losing their health insurance, 2026 may be its time. MUSICAL CODA
Patients Wary of Governments, Companies Pushing AI as a Rural Healthcare Solution
The $50 billion federal Rural Health Transformation Program is set to flood rural America with new AI health tools. That’s despite little evidence on whether health-related AI can improve access to care and patient health in those communities.
Same Knee Surgery, Twice the Price: Hospital Monopolies Push Up Healthcare Costs
A federal disclosure rule is offering new insight on the effect of healthcare monopolies on pricing, following a wave of U.S. mergers.
KFF HEALTH NEWS: Medicaid Work Rule Leaves Homeless People in the Cold
By Katheryn Houghton KFF Health News August 6, 2026 MISSOULA, Mont. — Tywon Pugh has seizures that make it hard to find and keep a job. “They called me a ‘liability to the job site,’” Pugh said, recalling the words of his manager when a seizure cost him his last job at a fast-food restaurant
Insurers want to hike small businesses’ premiums by 14% next year: KFF
It’s becoming harder for small employers to offer insurance coverage, and another year of double-digit premium increases won’t help. Insurers say their hands are tied.
Budget Battle Erupts in Nation’s Capital Over Opioid Settlement Money
Washington, D.C.’s 2027 fiscal-year blueprint reflects a debate playing out around the U.S.: whether opioid settlement money should be used to free up taxpayer dollars by paying for existing responsibilities instead of new programs.
How Much and Why Premiums Are Going Up for Small Businesses in 2027
Small businesses that offer health insurance to their employees could see health costs rise in 2027, according to an analysis of preliminary rate filings from all 50 states and DC. Nearly 300 insurers offering small group coverage reported a median proposed premium increase of 14% for next year.
Medicaid Work Rule Leaves Homeless People in the Cold
Conservatives who have long pushed for Medicaid work requirements often said vulnerable people would get a pass. But the federal government’s list of exemptions left off homeless people.
Watch: Democratic Senator Proposes a Fix for American Healthcare — Covering All Kids
Sen. Andy Kim of New Jersey wants to offer universal healthcare until age 26. He sat down with KFF Health News’ Julie Rovner to answer the question: “How Would You Fix It?”
How much and why premiums are going up for small businesses in 2027 - Peterson-KFF Health System Tracker
Each year, health insurers submit rate filings to state regulators outlining their expectations for the coming year and proposing premium changes for Affordable Care Act (ACA)-compliant plans. This analysis examines filings in the small group market, which covers plans offered to small businesses (generally with 50 or fewer full-time equivalent employees). Some of this coverage is […]
Pediatricians and Health Departments Sidestep Trump’s CDC on Vaccine Guidance
When the Trump administration upended years of vaccine advice, it left pediatricians in a quandary. Many say they can no longer direct families to the CDC as a trusted source of information. So some are creating their own.
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Does public health *need* MAHA?
Last week, our friend Dr. Craig Spencer sparked an ongoing volatile discussion with his Atlantic article “Public Health Needs MAHA.” Some have come out in strong dissent, others are cheering, and others are simply lamenting that we find ourselves in such a divided world to begin with. We will dare to dip our toes in these controversial waters, too. Does public health need MAHA? We think in some ways yes, and in other ways, no. MAHA leaders versus the everyday MAHA supporter The vitriol in this debate mostly comes from one collapsed distinction: the leadership of MAHA is not necessarily the same as the people who support it. Say “MAHA” and most people picture RFK Jr. Fair enough, as he coined the term and holds most of the power. And, yes, some MAHA followers treat Kennedy as something close to a saint. But talk to the grassroots, and it’s not a monolith. They’re Republicans, Democrats, and Independents. People who distrust vaccines and vaccine supporters. It’s a wide, eclectic coalition. The data backs this too: 4 in 10 Americans support the movement—that’s a lot of people! But according to polls, vaccines and medical choice (the issues most tied to Kennedy personally) are cited by only 4% as their reason for supporting the movement. For many, the motivations are much broader. Many MAHA supporters are signing up for the idea that “something needs to change” with health in this country. They’re asking good-faith questions about corporate influence on our health systems, health care costs, nutrition, chemicals, and clean air and water. These are all questions that plenty of public health professionals recognize as legitimate and also care about very deeply. Blurring the lines between the leadership and grassroots does real damage in two important ways: It hands the 4 in 10 exactly the narrative already fed—that the health ecosystem doesn’t listen, doesn’t care, and paints every critic with the same brush. It gives the actual bad actor more power. RFK Jr. has done irreparable damage and can’t be trusted. What the MAHA movement gets right A healthy population is something the public health field was literally built on, and many of these topics are things we have dedicated our lives to. Yet the MAHA movement has captivated nearly half the country in a way the public health establishment has failed to achieve. So that means MAHA is doing something right. Some of it may be timing (after a Covid-19 pandemic and deep frustration and mistrust with institutions). The movement also does three other things really well: 1. It gives a new, louder voice to system failures. While MAHA is not a monolith, one theme stays consistent across their stories: the system failed them. For some, it was the system that flooded their communities with opioids and then walked away. For others, it was the system that let their business collapse during Covid with no safety net in sight. For others still, it was the system that failed to help them manage a complex chronic illness, bouncing them from physician to physician without any real answers. And in many ways, our health ecosystems are failing Americans. Why are medical bills so incomprehensible? Why do some kids get a healthy school lunch and others don’t? Why do an epidemiologist and a MD/PhD student have to start newsletters in the middle of the biggest public health emergency in a century, just so people can get straight information? Because the systems failed. This deep-seated frustration driving many Americans to search for solutions elsewhere needs to be recognized. 2. MAHA has brilliant comms central to their efforts. MAHA figured out something most health institutions still have not: the information landscape changed. It’s participatory now, not top-down; influence runs through many nodes in a community, not one institution; and storytelling and telling audiences “what you really think” moves people more than data dumps do. MAHA goes where audiences are listening, using podcasts, social media, and memes in ways most health institutions would scoff at—but it works. 3. They are very good at organizing. A MAHA meeting feels like a rally: energy, speakers, music, and most importantly, an action for everyone. Someone’s writing the next policy brief, someone’s seeding a narrative, someone knows the next legislative deadline, someone’s sending the text messages for a campaign. None of this is new (ask the civil rights movement), but MAHA knows it works and has capitalized on it. What MAHA gets wrong This list could be much longer, and this newsletter has spent a lot of time covering it, but here are a few things: Poor use of scientific evidence. This is the fundamental problem with many MAHA policies: the hype outpaces the science, and experts are often villainized for pointing this out. MAHA leadership has traded real solutions for cheap wins. For example, instead of taking on the powerful food industry and passing real reforms, it has celebrated french fries made of beef tallow and taken out artificial dyes from still very sugary children’s cereal. These changes won’t move the needle on America’s diet. MAHA leadership has tried to dismantle vaccine access in the U.S. While many MAHA supporters emphasize other issues, the effort to change vaccine policy has become MAHA’s signature effort. This is not surprising given RFK Jr.’s extensive track record campaigning against vaccines. It has rallied behind the wrong leader. RFK Jr. has a decades-long track record of villifying doctors, scientists, and public health workers, well before he became HHS secretary. He is known for his decades-long work sowing distrust in vaccines as well as life-saving treatments like antiretroviral therapy for HIV. This is not a serious person who can move the needle on health in the U.S, and he has already done serious damage. Public health needs more than defense Defending the evidence is absolutely necessary so health in the U.S. doesn’t move further backward. The public health establishment is very good at defense. The problem is this defense often sounds like defending the status quo, which has failed many people. Public health needs to offer an alternative to RFK Jr.’s MAHA—one that is rooted in evidence, truly listens to and addresses people’s frustrations, and has innovative solutions and the courage to change the systems. How do we get there? Find common ground. Do you know what most people care most about? The abysmal cost of healthcare. Start there. Fight for the human loudly. Too often, communications and engagement center on science with a capital S, funding mechanisms, or the CDC/FDA/NIH. Not the person. So the public doesn’t see themselves in it. Instead, they see people fighting for the very powerful systems that they feel negatively impact their health and well-being. Let the public feel and hear that you see their frustrations, you get it, and you’re fighting for them within the system. Recognize when pro-science messages are alienating people. Facts absolutely matter, but angrily venting only alienates people further. Our friend Elisabeth Marnik recently wrote a New York Times article about her experience growing up unvaccinated and how listening and empathetic conversation are the only ways to reach people that really work (a position backed by communication science). Her comments section was full of hateful comments from pro-vaccine individuals attacking her for daring to suggest we approach vaccine-hesitant individuals with empathy. It is possible to both stand firm behind scientific evidence and empathize with people who don’t trust it. Lean into politics smartly. Often, public health has shied away from politics: Don’t touch it, lest you get burned. But this fails to recognize that the third rail is what fuels the train: who is elected determines our budgets, our priorities, and our authority. Being political means being very savvy in strategy on both sides of the aisle, knowing your audience, and recognizing that political capital is as scarce as financial resources and needs to be allocated accordingly. Bottom line So does public health need MAHA? That’s not really the right question. Public health has a responsibility not to dismiss 40% of the country who feel heard by this movement and are frustrated that the system has failed them. And it has a responsibility to stick to the evidence and recognize MAHA leadership for what it is: a danger to our nation’s health. Both can, and should, be done. Love, YLE and KP A big thanks to Craig Spencer, who had the courage to put his neck out there to start a much-needed discussion at such a critical moment—one that is determining the identity of an entire field. Kristen Panthagani, MD, PhD is completing an emergency medicine residency and research fellowship focusing on health literacy and communication. In her free time, she writes the newsletters You Can Know Things debunking health myths and rumors and The Public Health Roundup. Views expressed belong to KP, not her employer. Your Local Epidemiologist (YLE) comprises a team of experts, ranging from physicians to immunologists to epidemiologists to nutritionists, working together with one goal: to “translate” ever-evolving public health science so that people are well-equipped to make evidence-based decisions. The YLE suite of newsletters reaches over 475,000 people across more than 132 countries. This newsletter is free to everyone, thanks to the generous support of fellow YLE community members. To support the effort, subscribe or upgrade below: Subscribe
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They Worked To Protect Public Health. Now They Want the Public’s Votes.
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Trump's CDC Nominee Praises Vaccines, Without Vowing Independence From RFK Jr.
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