Year in Review: In a 2025 Defined by Huge Health Care Cuts, Health Advocates Still Advanced an Affordability Agenda

12.23.2025 /Press Release

WASHINGTON, D.C. - Health care cuts and cost increases made major headlines in 2025, and Families USA, the longtime health care consumer advocacy organization, expects that to continue in 2026, especially as the coverage losses and other consequences of deliberate decisions by policymakers become clearer in the new year. In reviewing the past year of major federal setbacks, Families USA is also highlighting how health care affordability rose in public prominence, and how advocates made some less-noticed progress this year to address health care costs, including regarding hospital pricing, prescription drug costs, and state-level action on affordability.

"Overall, 2025 was a historically horrible year for health coverage, access, and costs, with the passage of the biggest cuts to Medicaid in history and capped with the failure of Congress to extend assistance for Americans to afford health coverage." said Anthony Wright, executive director of Families USA. "American consumers are just starting to feel the consequences, which will reverberate in our health system for years to come."

These coming consequences include:

• Over 20 million people who purchase marketplace coverage will see major premiums spike - over $1,000 a year, on average, and for many, much more.
• Over $900 billion in Medicaid cuts will make it harder for millions of people to get on and stay on coverage and will cause future cuts to Medicaid benefits and critical services and the health system on which we all rely.
• In the end, 15 million more Americans could end up uninsured, due to policy decisions like those in H.R.1 and other administrative actions.
• Due to administration attacks, many of our most vulnerable communities will see their access to care restricted, including women and their reproductive health, immigrants (including those with legal documentation), and the trans community.
• All Americans will be impacted by cuts to public health and research, including the systems that ensure access and coverage for vaccines and preventive care, track diseases and disparities, and prepare us for the next emergency or pandemic.

"Americans voted for affordability, but many policy decisions are actually increasing health premiums and prices, while cutting coverage and care. These fights helped put health care affordability and access front and center for the public, which wants to cut costs, not care." said Wright. "Despite the Congressional cuts, advocates for health care affordability were able to make progress at specific agencies and at the state level. We will build on these wins to advance a more ambitious affordability agenda in the new year."

These notable 2025 health policy accomplishments reflect strong public demand for action to lower health care costs and rein in corporate practices that drive ever-rising prices, which include:

• Hospital Pricing and Payment Reforms: The Centers for Medicare & Medicaid Services finalized several Medicare payment reforms long championed by Families USA and the Consumers First coalition. These include "same service, same price " policies for physician-administered drugs in hospital outpatient settings and strengthened hospital price transparency requirements. The changes are projected to save Medicare billions while lowering costs for seniors and improving payment stability for primary care providers.
• Lowering Prescription Drug Prices: The Medicare Prescription Drug Price Negotiation Program continued to be implemented, delivering more savings across a broader range of life-saving medications. As part of the Inflation Reduction Act which many feared would be repealed, the program and other provisions to lower prescription drug costs proved their durability across administrations, underscoring its bipartisan popularity and growing impact on affordability.
• State-Level Leadership on Costs: States stepped in to advance affordability on their own. Colorado's Prescription Drug Affordability Board set payment limits tied to Medicare-negotiated prices, with Maryland poised to follow. Additional states are advancing similar efforts. Legislatures in California, Indiana, Nevada, Vermont, Washington and other states enacted laws to curb excessive hospital pricing, slow consolidation, and strengthen oversight of private equity in health care.

"Even in a contentious environment, these actions show progress is possible, and policymakers can take meaningful action to lower costs and protect consumers," said Wright. "Americans are facing an affordability crisis that must be addressed. The public is ready for bold reforms, and policymakers across all levels of government should resolve to create a more affordable and accessible health system for all in 2026 and beyond."

"Congress should begin 2026 with an easy, bipartisan win to stop the spike in premiums, and pass the extension of enhanced tax credits as an entry point to address the drivers of high health care costs more broadly." Wright continued. "Every day Congress delays does damage to family finances and to our health system, but it is still not too late to act."

Families USA staff are available to provide expert analysis and patient perspectives on health care affordability, the Affordable Care Act, Medicaid, Medicare, prescription drug pricing, hospital consolidation, and state and federal policy trends heading into 2026.