Health Advice



America worries about health costs -- and voters want to hear from Biden and Republicans

Julie Appleby and Phil Galewitz, KFF Health News on

Published in Health & Fitness

Health care costs continue to rise for many Americans. The cost of employer-sponsored health plans have hit new highs in the past few months, raising costs for employers and workers alike. Experts have attributed the increase to high demand and expensive prices for certain drugs and treatments, notably weight loss drugs, as well as to medical inflation.

Meanwhile, the ACA is popular. The KFF poll found that more adults want to see the program expanded than scaled back. And a record 21.3 million people signed up for coverage in 2024, about 5 million of them new customers.

Enrollment in Republican-dominated states has grown fastest, with year-over-year increases of 80% in West Virginia, nearly 76% in Louisiana, and 62% in Ohio, according to the Centers for Medicare & Medicaid Services.

Public support for Obamacare and record enrollment in its coverage have made it politically perilous for Republicans to pursue the law’s repeal, especially without a robust alternative. That hasn’t stopped Trump from raising that prospect on the campaign trail, though it’s hard to find any other Republican candidate willing to step out on the same limb.

“The more he talks about it, the more other candidates have to start answering for it,” said Jarrett Lewis, a partner at Public Opinion Strategies, a GOP polling firm.

“Will a conversation about repeal-and-replace resonate with suburban women in Maricopa County?” he said, referring to the populous county in Arizona known for being a political bellwether. “I would steer clear of that if I was a candidate.”


Biden and his campaign have pounced on Trump’s talk of repeal. The president has said he wants to make permanent the enhanced premium subsidies he signed into law during the pandemic that are credited with helping to increase enrollment.

Republican advisers generally recommend that their candidates promote “a market-based system that has the consumer much more engaged,” said Lewis, citing short-term insurance plans as an example. “In the minds of Republicans, there is a pool of people that this would benefit. It may not be beneficial for everyone, but attractive to some.”

Biden and his allies have criticized short-term insurance plans — which Trump made more widely available — as “junk insurance” that doesn’t cover care for serious conditions or illnesses.

Entitlements Are Off-Limits


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©2024 KFF Health News. Distributed by Tribune Content Agency, LLC.


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