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Summary of Costs and Impact of the Prescription Drug Provisions in the Build Back Better Act

Nov 23, 2021

News Release

As the House-passed Build Back Better Act moves to the Senate, a new explainer from KFF summarizes the key prescription drug provisions within the broader budget reconciliation bill. These provisions would lower prescription drug costs paid by people with Medicare and private insurance and curb drug spending by the federal government and private payers. The Congressional Budget Office estimates federal budget savings from the drug pricing provisions would be $297 billion over 10 years. Although…

Unpacking the Prescription Drug Provisions of the Build Back Better Act

Event Date: Dec 8, 2021

Event

As the Build Back Better Act shifts from the House to the Senate, there’s considerable interest in provisions that would lower the cost of prescription drugs. The House-passed bill would allow the federal government to negotiate prices for some high-cost drugs in Medicare, and set a hard cap on out-of-pocket drug spending for Medicare Part D enrollees. For people with Medicare and private insurance, the legislation would limit annual increases in drug prices and cap…

Nearly 7 in 10 Medicare Beneficiaries Did Not Compare Plans During Medicare’s Open Enrollment Period

Sep 26, 2024

Issue Brief

This brief examines the share of Medicare beneficiaries who reviewed their coverage and compared plans during the open enrollment period for 2022 (that takes place in the Fall of 2021), and who made use of Medicare’s official information resources, as well as variations by demographic groups. Overall, nearly 7 in 10 Medicare beneficiaries did not compare their own source of Medicare coverage with other Medicare options offered in their area.

State Medicaid Officials Project Flat Enrollment Post Unwinding but Increased Spending and Budget Pressures, as States Prepare for Impact of Federal Medicaid Policy Changes

Nov 13, 2025

News Release

As states completed the “unwinding” of pandemic-era continuous coverage, Medicaid enrollment fell 7.6% in FY 2025 and is expected to be largely flat in FY 2026. At the same time, total Medicaid spending grew by 8.6% in FY 2025 and is expected to grow by 7.9% in FY 2026.

Navigating the Maze: A Look at Patient Cost-Sharing Complexities and Consumer Protections

Mar 28, 2025

Issue Brief

This brief focuses on consumers’ understanding of health insurance costs and examines existing federal protections that seek to address barriers to understanding the cost of coverage and care, such as price transparency, self-service price estimator tools, and simplifying cost-sharing designs.

As ACA Deadline Approaches, Some Price-Sensitive Consumers May Consider Switching to Short-Term Plans

Dec 8, 2025

Quick Insights

As the ACA open enrollment deadline approaches amid the expiration of the enhanced premium tax credits, nearly six in 10 Marketplace enrollees say they would not be able to afford $300 more in annual health care costs, which may lead some to alternative coverage products, such as short-term plans, a type of private coverage that tends to have lower premiums but few consumer protections and limited benefits.

A View of Medicaid Today and a Look Ahead: Balancing Access, Budgets and Upcoming Changes

Nov 13, 2025

Report

This report highlights key policy priorities and issues state Medicaid programs focused on in FY 2025 and are prioritizing in FY 2026.

Affordability Is the Issue Now, But Look for the Uninsured to Make a Comeback

Apr 10, 2026

From Drew Altman

A new column on the uninsured from President and CEO Dr. Drew Altman explains: “The uninsured is not the most politically salient problem in health care now, that’s affordability, nor is it the non-problem some say it is. But it’s coming back. And the problem of the chronically ill uninsured is glaring.” Read more.

What to Know About the BALANCE Model for GLP-1s in Medicare and Medicaid and the Medicare GLP-1 Bridge

May 11, 2026

Issue Brief

This brief describes current coverage of GLP-1s in Medicare and Medicaid, the Centers for Medicare & Medicaid Services’ (CMS) efforts to expand access and lower costs for GLP-1s through temporary demonstration programs including the BALANCE Model, and potential impacts on beneficiaries and program budgets.

A Closer Look at North Carolina’s Implementation of the 2025 Reconciliation Law Medicaid Provisions and Other Changes Amid Medicaid Budget Shortfalls

May 29, 2026

Policy Watch

This policy watch provides initial insight into how North Carolina is preparing to implement certain Medicaid provisions of the 2025 reconciliation law and how other policy changes may affect coverage and access to care.

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