Deepest sympathies for the many great journalists laid off at the Washington Post today. A comment on many things about the news industry and why I prefer our non profit model with our own stable funding and no need to chase revenue or clicks.

It’s not going to be a health care election but it will partly be a health cost election. Our new poll: on.kff.org/3LGVtUh

When you think about us having a health care cost problem, which part of this Venn diagram comes to mind first? @drewaltman.bsky.social www.kff.org/from-drew-al...

Everyone wants to reduce health care spending – their own, often at the expense of someone else’s health spending. No one really wants to take on underlying costs. My latest column: on.kff.org/4a11umO

States are starting to cut Medicaid as revenues fall and federal cuts loom, making lots of different cuts to spread the pain and ease the politics. But work requirements and the $1T in federal Medicaid cuts have not hit yet. on.kff.org/45rYOND

Trump is not interested in Greenland’s rare earth minerals, or national security. He wants their single payer health system.

We have been trying to analyze the Trump health “plan” but I worry that unless Congress puts something real together we are analyzing air. Big Q’s such as are pre-x protected are impossible to answer from their Fact Sheet. What we do know: it partly captured a news cycle.

It looks like Trump’s “buy your own insurance“ plan would largely do away with pre-x protections and the Marketplaces, but not insurance companies he doesn’t like who would still provide most of the coverage.

Today Trump called on R’s to “ own health care”, an issue they have never won. But with what? Trump favors narrow, glitzy industry deals, not comprehensive plans dealing with coverage and costs. Can that formula work? My column: on.kff.org/4ssYisr

The Rural Fund grants are a grab bag from telehealth to mobile health to parks and trails for recreation. Our analysis based on rural population:

1 in 4 in our Marketplace enrollee survey say they will drop insurance. But 1 in 3 will pick cheaper high deductible plans, many with deductibles and co-pays they cannot afford. on.kff.org/4464PPo

No one likes prior authorization review. But could we get rid of it? My new column: www.kff.org/from-drew-al...

Our survey of immigrants with the NYT, out now, shows while the immigration crackdown has caused fear and anxiety, immigrants still prefer the U.S. to where they came from and are optimistic about the future. With that resilience, nativism can’t win long term.

With all the talk about ACA costs being out of control, they are actually quite similar to and slightly less than employer (group) health costs. The problem is health care costs, not the ACA.

If Republicans decide to make a deal on ACA tax credits to reduce the political danger for moderate R’s in the midterms, there are compromises with Democrats that can work. See Jonathan Cohn in Bulwark today. That’s if.

With one vote on the ACA tax credits in December, no agreement on a plan, and no commitment from the House or Trump, there is no apparent path to extending the credits. It means the issue will prosecuted in the midterms, and it means pain for tens of millions of Americans.

Not this again. Insurance provides access to health care, so it’s actually health care that “doesn’t save lives”, statistically in the aggregate, because most people aren’t sick. But if you get sick, it absolutely does. Anybody ready to go without it. www.washingtonpost.com/business/202...

Trump has now called for replacing the ACA (again) so people can buy skimpier policies from insurance companies (again)?? In a shutdown debate where tax credits are the issue not the popular law. As a negotiating strategy that’s tripling down.

Many implications of the big Dem win tonight. One for health care: it could provide an incentive for Republicans to make a deal on ACA tax credits to deny Democrats the issue in the midterms and further momentum.

Who are MAHA parents? The breakdown from our poll with the @washingtonpost.com: on.kff.org/477Oo5L

GLP-1s in the real world of Mississippi Medicaid: the people and the costs. Check out this story from our Phil Galewitz:

Four in ten who buy their own coverage say they would go without coverage if ACA premiums doubled. They will increase 114% if enhanced tax credits are not extended: on.kff.org/4nACyIk

Politically its Republicans in swing districts who could lose who have to worry most about ACA premium hikes blowing back on them. But its Republicans everywhere whose constituents will be most affected by the hikes: on.kff.org/3VQ3kjF

Another reason health costs will spike. Get ready for a run on GLP-1’s by admirals and generals. thehill.com/policy/defen...

They are going to need a new poster. Our new number, based on new information: ACA premiums will rise an average of 114%. on.kff.org/3WfWxjj

Two KFF findings Republicans might want to consider when deciding how much they care about the looming 100+% premium spike: More than 1/4 of farmers and ranchers are marketplace enrollees. Almost 1/2 of enrollees are small business owners or work for them.

The Senate’s failure to pass a spending bill last week raises the stakes for 24M people in the ACA marketplaces who could see significantly higher premiums next year if the enhanced tax credits expire. More from @drewaltman.bsky.social via @nytimes.com: nyti.ms/46k2XE2

In his latest column, KFF’s @drewaltman.bsky.social explains how higher health insurance premiums in the marketplaces — if enhanced ACA tax credits expire — could strain family budgets already stretched by food, housing, and utility costs. https://on.kff.org/48wSuXi

How will it affect family budgets if the ACA enhanced tax credits are not extended? For lower income (23k) the increase alone is a quarter of what they spend on food. More moderate income (80k), well more than 2x their food budget. My latest column:

Our tracking polls on health misinformation and trust have found a large muddled middle. Confused and unsure who and what to believe they are up for grabs. Yesterday’s announcement on Tylenol and autism will add significantly to it.

We work hard at @kff.org to be experts who are communicators, too. It’s why I say “communications is everyone’s job” here. A great example today in JAMA from @larrylevitt.bsky.social Levitt — storylines for The Pitt.

Will it add to the seemingly growing pressure to make a deal and extend the enhanced ACA tax credits to learn that - half of all marketplace enrollees work for small businesses or are self employed?

Our poll of parents on vaccines with the Washington Post suggests there may be more blowback than imitation after Florida’s move to eliminate childhood vax requirements. Even 7 in 10 MAGA parents support the requirements (and 82% of FLA parents).

As sources of vaccine info move away from CDC and fragment — to doctors, state health departments, professional societies — this is who the public trusts:

The ACA tax credits are the biggest unresolved health policy issue before Congress. But with both sides bobbing and weaving, and the news media focused elsewhere, the prognosis is unclear. on.kff.org/3HTxsHy

Everybody is schizophrenic about prior authorization. They hate it, but they need it to control costs and limit unnecessary care. So they try to do it smarter. Except there’s one group who has no use for it at all: Patients.

Just 14% of the public have a lot of trust in CDC on vaccines. How many will trust it after this week’s ugly purge? Was that the idea?

Katrina: KFF remembers the pain and the progress: www.washingtonpost.com/wp-srv/speci...

Just 16% of the public say mRNA vaccines are unsafe. Even 59% of MAGA supporters say they “don’t know enough to say.” Confusion, not trust, is the vaccine issue. on.kff.org/3HlGRaF

Is lack of confidence in the safety of vaccines the problem, or distrust in the traditional sources of information about vaccines? My latest column:

Three of the ESPN stories about our survey with them of 1988 NFL players: 1) Survey: Most NFL retirees would play again despite costs

When football "trumps" health? Football has serious long-term health consequences, and in our novel survey of 1988 pro players with ESPN out today, the pain and suffering comes pouring out, even as the players also say they would do it all over again.

Are we hyping the role of influencers in health? My latest column, with new data.

Sara Kliff’s great piece inside the R mind on health coverage: nytimes.com/2025/08/01/h... R’s have always discounted coverage but won’t say it to voters or give up their own. And viewed Medicaid as welfare warranting work: on.kff.org/4ogpUix

Prior-auth may be the pre-x of today. Most see it as a big problem for them. Few think the recently announced voluntary initiative to curb it will amount to much. Our latest tracking poll:

65% of Medicaid beneficiaries say the new tax and spending law will hurt them. From our latest tracking poll:

CBO now says there will be 10m more uninsured from the “OBBB.” But the estimate of 4.2m uninsured from the enhanced ACA tax credits expiring at the end of the year stands. So we are looking at 14+ million more uninsured over 10 years unless that changes.

The $50 billion rural hospital/health care grant program can’t help but do a lot of good. It’s also likely to be highly political and isn’t timed or targeted to help a lot with Medicaid cuts. My latest column:

The ACA was not popular when it passed (remember death panels), but it was more popular than the “ OBBB” is today.

Did conservative R’s achieve THEIR “OBBB” health goals? SPENDING CUTS: A trillion. Yes. POLICY: No block grant or per capita cap. The expansion remains. Work requirements. Mixed. POLITICS: Most cuts impact after midterms. TBD. Is it good for the country? Different question.