Larry Levitt
@larrylevitt.bsky.social
Executive Vice President for Health Policy, KFF. Cal Bear.
https://www.kff.org/person/larry-levitt/
https://www.kff.org/person/larry-levitt/
New: Health care affordability is a big concern for people. But, don't underestimate the complexity of our health insurance system as a burden, especially prior authorization.
www.kff.org/public-opini...
www.kff.org/public-opini...
February 2, 2026 at 3:09 PM
New: Health care affordability is a big concern for people. But, don't underestimate the complexity of our health insurance system as a burden, especially prior authorization.
www.kff.org/public-opini...
www.kff.org/public-opini...
Medicare Advantage insurers made 53 million prior authorization determinations in 2024. That's an average of 1.7 determinations per enrollee. It's no wonder patients, physicians, and hospitals find the system burdensome and complex.
www.kff.org/medicare/med...
www.kff.org/medicare/med...
January 29, 2026 at 6:00 PM
Medicare Advantage insurers made 53 million prior authorization determinations in 2024. That's an average of 1.7 determinations per enrollee. It's no wonder patients, physicians, and hospitals find the system burdensome and complex.
www.kff.org/medicare/med...
www.kff.org/medicare/med...
New federal data shows 23 million people have signed up for ACA coverage, 1.3 million fewer than last year as enhanced tax credits expire.
The number of people losing coverage will rise as people can't make their premium payments, which are more than doubling on average.
www.cms.gov/newsroom/fac...
The number of people losing coverage will rise as people can't make their premium payments, which are more than doubling on average.
www.cms.gov/newsroom/fac...
January 28, 2026 at 8:01 PM
New federal data shows 23 million people have signed up for ACA coverage, 1.3 million fewer than last year as enhanced tax credits expire.
The number of people losing coverage will rise as people can't make their premium payments, which are more than doubling on average.
www.cms.gov/newsroom/fac...
The number of people losing coverage will rise as people can't make their premium payments, which are more than doubling on average.
www.cms.gov/newsroom/fac...
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...
@drewaltman.bsky.social
www.kff.org/from-drew-al...
January 28, 2026 at 3:19 PM
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...
@drewaltman.bsky.social
www.kff.org/from-drew-al...
The effects of enhanced ACA premium subsidies expiring are starting to hit home.
www.wsj.com/health/healt...
www.wsj.com/health/healt...
January 27, 2026 at 2:49 PM
The effects of enhanced ACA premium subsidies expiring are starting to hit home.
www.wsj.com/health/healt...
www.wsj.com/health/healt...
If we're going to talk about the role health insurers play in the cost of health care, we should be talking more about Medicare Advantage than the ACA.
www.kff.org/medicare/hea...
www.kff.org/medicare/hea...
January 22, 2026 at 3:30 PM
If we're going to talk about the role health insurers play in the cost of health care, we should be talking more about Medicare Advantage than the ACA.
www.kff.org/medicare/hea...
www.kff.org/medicare/hea...
President Trump is suggesting here that people could use government subsidies to buy insurance that doesn’t comply with ACA rules, including coverage of pre-existing conditions. That could lower costs for healthy people, but send the ACA marketplace into a death spiral.
January 15, 2026 at 5:10 PM
President Trump is suggesting here that people could use government subsidies to buy insurance that doesn’t comply with ACA rules, including coverage of pre-existing conditions. That could lower costs for healthy people, but send the ACA marketplace into a death spiral.
If you want to focus on insurance company overhead and profit, Medicare Advantage is the market that stands out as an outlier.
www.kff.org/medicare/hea...
www.kff.org/medicare/hea...
January 9, 2026 at 7:46 PM
If you want to focus on insurance company overhead and profit, Medicare Advantage is the market that stands out as an outlier.
www.kff.org/medicare/hea...
www.kff.org/medicare/hea...
My latest in @jamahealthforum.com looks at health care affordability -- or, more aptly, unaffordability -- in the context of the debate over enhanced ACA premium tax credits.
jamanetwork.com/journals/jam...
jamanetwork.com/journals/jam...
January 8, 2026 at 4:31 PM
My latest in @jamahealthforum.com looks at health care affordability -- or, more aptly, unaffordability -- in the context of the debate over enhanced ACA premium tax credits.
jamanetwork.com/journals/jam...
jamanetwork.com/journals/jam...
New: With first year awards from the rural health transformation fund out, our analysis shows wide variation in the amount per rural resident across states.
www.kff.org/state-health...
www.kff.org/state-health...
January 6, 2026 at 6:15 PM
New: With first year awards from the rural health transformation fund out, our analysis shows wide variation in the amount per rural resident across states.
www.kff.org/state-health...
www.kff.org/state-health...
I'd say this pretty much seems up the ACA debate in the Senate today.
www.politico.com/live-updates...
www.politico.com/live-updates...
December 11, 2025 at 2:46 PM
I'd say this pretty much seems up the ACA debate in the Senate today.
www.politico.com/live-updates...
www.politico.com/live-updates...
Pre-existing conditions -- which led to a denial of individual health insurance before the ACA -- are highest among older working age people without a college degree.
www.bloomberg.com/opinion/arti...
www.bloomberg.com/opinion/arti...
December 10, 2025 at 4:13 PM
Pre-existing conditions -- which led to a denial of individual health insurance before the ACA -- are highest among older working age people without a college degree.
www.bloomberg.com/opinion/arti...
www.bloomberg.com/opinion/arti...
Under the Senate Republican ACA plan, premium payments would still more than double next year.
Healthy people could be better off in a high deductible plan with a health savings account.
People who are sick would face big premium increases or a deductible they can't afford.
Healthy people could be better off in a high deductible plan with a health savings account.
People who are sick would face big premium increases or a deductible they can't afford.
December 9, 2025 at 8:43 PM
Under the Senate Republican ACA plan, premium payments would still more than double next year.
Healthy people could be better off in a high deductible plan with a health savings account.
People who are sick would face big premium increases or a deductible they can't afford.
Healthy people could be better off in a high deductible plan with a health savings account.
People who are sick would face big premium increases or a deductible they can't afford.
I was genuinely interested to see President Trump's health plan today. Guess we'll have to wait longer.
November 24, 2025 at 6:37 PM
I was genuinely interested to see President Trump's health plan today. Guess we'll have to wait longer.
Proposals from Senators Scott and Cassidy to convert ACA premium tax credits into health accounts present trade-offs that benefit healthy people at the expense of sick people. Senator Scott's proposal, in particular, would destabilize the insurance market in some states.
www.kff.org/affordable-c...
www.kff.org/affordable-c...
November 21, 2025 at 10:43 PM
Proposals from Senators Scott and Cassidy to convert ACA premium tax credits into health accounts present trade-offs that benefit healthy people at the expense of sick people. Senator Scott's proposal, in particular, would destabilize the insurance market in some states.
www.kff.org/affordable-c...
www.kff.org/affordable-c...
ACA enrollment growth since enhanced premium tax credits were put in place is dramatically skewed towards red states. Yet, no Republican voted for the ACA originally, or for the enhanced tax credits.
www.kff.org/affordable-c...
www.kff.org/affordable-c...
November 21, 2025 at 3:24 PM
ACA enrollment growth since enhanced premium tax credits were put in place is dramatically skewed towards red states. Yet, no Republican voted for the ACA originally, or for the enhanced tax credits.
www.kff.org/affordable-c...
www.kff.org/affordable-c...
Leaving aside the issue that people buying insurance would buy it from insurance companies. This sounds like an effort to let people bypass the ACA. Healthy people could buy cheaper insurance that doesn't cover pre-existing conditions, sending the ACA into a premium death spiral.
November 18, 2025 at 3:02 PM
Leaving aside the issue that people buying insurance would buy it from insurance companies. This sounds like an effort to let people bypass the ACA. Healthy people could buy cheaper insurance that doesn't cover pre-existing conditions, sending the ACA into a premium death spiral.
A bipartisan deal on ACA premium tax credits is far from certain. If it happens, it will mean threading a very thin needle.
@citizencohn.bsky.social
www.thebulwark.com/p/here-is-ho...
@citizencohn.bsky.social
www.thebulwark.com/p/here-is-ho...
November 12, 2025 at 3:05 PM
A bipartisan deal on ACA premium tax credits is far from certain. If it happens, it will mean threading a very thin needle.
@citizencohn.bsky.social
www.thebulwark.com/p/here-is-ho...
@citizencohn.bsky.social
www.thebulwark.com/p/here-is-ho...
KFF's estimate that out-of-pocket ACA premiums will increase if enhanced tax credits expire by an average of 114% has been widely reported. But, it varies a lot, especially by income. Here's what increases look like in dollar terms -- from $378 at $18,000 to $1,836 at $45,000.
November 11, 2025 at 3:47 PM
KFF's estimate that out-of-pocket ACA premiums will increase if enhanced tax credits expire by an average of 114% has been widely reported. But, it varies a lot, especially by income. Here's what increases look like in dollar terms -- from $378 at $18,000 to $1,836 at $45,000.
You have to read between the lines here to imagine what President Trump is proposing. But, it sounds like it may be a plan for health accounts that could be used for insurance that doesn’t cover pre-existing conditions, which could create a death spiral in ACA plans that do.
November 8, 2025 at 6:14 PM
You have to read between the lines here to imagine what President Trump is proposing. But, it sounds like it may be a plan for health accounts that could be used for insurance that doesn’t cover pre-existing conditions, which could create a death spiral in ACA plans that do.
A lot of people are curious why insurers are increasing benchmark ACA premiums by an average of 26%. The publicly-available rate justifications from insurance companies typically look something like this. So, it's kind of hard to tell for sure.
October 30, 2025 at 6:39 PM
A lot of people are curious why insurers are increasing benchmark ACA premiums by an average of 26%. The publicly-available rate justifications from insurance companies typically look something like this. So, it's kind of hard to tell for sure.
I can't imagine a better use of @axios.com writing style than this "yes, but" from @maya-goldman.bsky.social about the 114% average out-of-pocket premium increase that ACA enrollees will face if enhanced tax credits expire.
www.axios.com/2025/10/30/a...
www.axios.com/2025/10/30/a...
October 30, 2025 at 1:31 PM
I can't imagine a better use of @axios.com writing style than this "yes, but" from @maya-goldman.bsky.social about the 114% average out-of-pocket premium increase that ACA enrollees will face if enhanced tax credits expire.
www.axios.com/2025/10/30/a...
www.axios.com/2025/10/30/a...
New: As open enrollment is about to begin, we estimate ACA insurers are raising premiums by an average of 26%. But if enhanced tax credits expire, 22 million enrollees will see their payments increase by way more than that, more than doubling.
www.kff.org/quick-take/a...
www.kff.org/quick-take/a...
October 29, 2025 at 12:51 AM
New: As open enrollment is about to begin, we estimate ACA insurers are raising premiums by an average of 26%. But if enhanced tax credits expire, 22 million enrollees will see their payments increase by way more than that, more than doubling.
www.kff.org/quick-take/a...
www.kff.org/quick-take/a...
There's been a lot of focus on our estimate that ACA enrollees will see their out-of-pocket premiums increase by 114% if enhanced tax credits expire. That may be a hard number to grasp. Another way of looking at it: What enrollees pay will go up by $1,016 on average.
www.kff.org/affordable-c...
www.kff.org/affordable-c...
October 23, 2025 at 8:41 PM
There's been a lot of focus on our estimate that ACA enrollees will see their out-of-pocket premiums increase by 114% if enhanced tax credits expire. That may be a hard number to grasp. Another way of looking at it: What enrollees pay will go up by $1,016 on average.
www.kff.org/affordable-c...
www.kff.org/affordable-c...
An official White House press release announces that an AstaZeneca inhaler will become available at a price discount of 654%.
www.whitehouse.gov/fact-sheets/...
www.whitehouse.gov/fact-sheets/...
October 10, 2025 at 10:41 PM
An official White House press release announces that an AstaZeneca inhaler will become available at a price discount of 654%.
www.whitehouse.gov/fact-sheets/...
www.whitehouse.gov/fact-sheets/...