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Affordable Care Act Marketplace insurers are raising premiums by an average of 18% next year, due in part to the expiring enhanced premium tax credits. Even if the credits are extended in shutdown negotiations, it is unlikely that insurers will have time to revise premiums, though the credits would still offer enrollees relief from them.
Under the Medicare Drug Price Negotiation Program, the federal government negotiates prices with drug companies for certain high-cost drugs covered under Medicare Part B and Part D. This brief provides information about several key aspects of the Medicare drug price negotiation program, with a focus on the 2028 implementation year.
With open enrollment less than a month away, a new KFF analysis suggests that the vast majority of the nation’s 67 million Medicare beneficiaries will not shop around among the coverage options for 2025 or switch plans. It’s a decision that could have a significant impact on enrollees’ coverage and costs. The analysis of federal data shows that nearly 7 in 10 Medicare beneficiaries (69%) did not compare their Medicare coverage with other Medicare options…
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.
This data note describes Medicaid prescription drug utilization and spending trends in calendar year 2020 compared to previous years to explore how the pandemic impacted Medicaid prescription drug utilization and spending.
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.
If enacted into law in its current form, and Congress takes no further action, [the House reconciliation bill's] increase in the deficit would trigger mandatory cuts, also known as sequestration, under the Statutory Pay-As-You-Go Act of 2010.
This brief estimates the number of current Marketplace enrollees with a mental health diagnosis to understand what changes in enrollment may mean for access to services. Among the 24.3 million Marketplace enrollees in 2025, over 4.4 million individuals are estimated to have at least one mental health diagnosis on a health care claim.
Allowing Medicare to negotiate drug prices on behalf of older Americans remains broadly popular across partisans, though many voters are unaware of the new law and the billions of dollars it is expected to save in 2026, a new KFF Health Tracking Poll finds.A large majority (85%) of voters say they support allowing the federal government to negotiate the price of some prescription drugs for people with Medicare. This includes at least three quarters of…
The State Health Insurance Assistance Program (SHIP) offers free counseling to help millions of Medicare beneficiaries make decisions about coverage. However, federal funding has been modest over the last decade, and federal administration of the program appears to be in transition.
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