V-BID Update: Healthcare Affordability Low as Spending Climbs, New Policy Solutions Emerge

In this Issue:

• Healthcare Affordability Falls Below 50% for First Time Since 2021
• Insurance Coverage and Burden for Adults with Vision Impairment
• Study Highlights Rising Imaging Cost-Sharing in Medicare Advantage
• CMS Projects U.S. Health Spending to Reach Nearly $9 Trillion by 2034
• Growing Use of Social Media and AI for Health Information
• Proposed Legislation Would Require 6 No-Cost Primary Care Visits Annually
• GOP Reconciliation Proposal Includes Employer Health Benefit Changes

Healthcare Affordability Falls Below 50% for First Time Since 2021

According to the latest West Health-Gallup Healthcare Affordability Index, fewer than half of U.S. adults (49%) are now considered “Cost Secure,” meaning they can consistently afford needed healthcare and prescription medications. Affordability declined across nearly all demographic groups in 2025, with particularly large decreases among young adults, older adults, women, and individuals with chronic or mental health conditions.

Insurance Coverage and Financial Burden for Adults With Vision Impairment

A new study found that insurance coverage improved for U.S. adults with vision impairment between 2014 and 2024, with uninsured rates declining and Medicaid enrollment increasing. Despite these gains, adults with vision impairment remained more than twice as likely as those without vision impairment to spend at least 10% of their family income on out-of-pocket medical expenses.

Study Highlights Rising Imaging Cost-Sharing in Medicare Advantage

According to the latest West Health-Gallup Healthcare Affordability Index, fewer than half of U.S. adults (49%) are now considered “Cost Secure,” meaning they can consistently afford needed healthcare and prescription medications. Affordability declined across nearly all demographic groups in 2025, with particularly large decreases among young adults, older adults, women, and individuals with chronic or mental health conditions.

CMS Projects U.S. Health Spending to Reach Nearly $9 Trillion by 2034

A new CMS analysis projects national health expenditures will grow from $5.3 trillion in 2024 to nearly $9 trillion by 2034, accounting for 20.6% of the U.S. economy. While health insurance coverage is expected to decline slightly over the next decade, CMS estimates that more than 90% of Americans will remain insured in 2034. The report attributes spending growth to increased use of healthcare services and goods, demographic changes, and evolving federal policies.

Growing Use of Social Media and AI for Health Information

A new KFF poll found that about three in ten U.S. adults use social media (31%) or AI tools (29%) at least monthly for health information and advice. While users most often cite convenience and learning from others with similar experiences, nearly one in five report turning to these platforms because of barriers to accessing or affording healthcare.

Proposed Legislation Would Require 6 No-Cost Primary Care Visits Annually

A bipartisan bill introduced in Congress would require employer-sponsored health plans to cover up to six primary care visits per year without cost-sharing. Supporters argue the proposal could improve access to preventive and routine care, strengthen patient-provider relationships, and help reduce downstream healthcare costs. If enacted, the requirement would apply to many employer-sponsored health plans and represent a significant expansion of no-cost primary care benefits.

GOP Reconciliation Proposal Includes Employer Health Benefit Changes

Lawmakers are considering allowing high-deductible plans that are compatible with HSAs to cover more services before the enrollees meet their deductibles. A new reconciliation bill would expand employer access to health plan data, create a new health coverage purchasing option, and enhance Health Savings Accounts (HSAs). Supporters argue the provisions could give employers greater flexibility in managing healthcare benefits and costs. Critics of similar proposals have argued that expanded reliance on HSAs and consumer-directed health arrangements may shift healthcare costs to patients and provide greater benefits to higher-income households than to lower-income workers.

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