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  • Recent Trends in GLP-1 Use and Spending in Medicare

    Issue Brief

    Ahead of the Trump administration’s planned expansion of Medicare coverage for GLP-1s to treat obesity through temporary models and the availability of Medicare’s negotiated price for certain GLP-1 products beginning in 2027, this analysis examines CMS’s Medicare Part D claims data from 2019 to 2024 to document the increase in the number of beneficiaries being treated with GLP-1 drugs and the growth in Medicare spending and claims for these drugs.

  • What health benefits do Marketplace plans cover?

    FAQs

    All qualified health plans offered in the Marketplace cover the "essential health benefits" (EHB), including: Ambulatory patient services (outpatient care you get without being admitted to a hospital) Emergency services Hospitalization Maternity and newborn care (care before and after your baby is born) Mental health and substance use disorder services, including behavioral health treatment Prescription drugs Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain…

  • 5 Key Facts About Medicaid Coverage for People Living in Rural Areas

    Issue Brief

    This brief presents five key facts about Medicaid coverage among individuals living in rural areas. It draws on recent data to describe enrollment patterns, differences by state Medicaid expansion status, characteristics of the rural Medicaid population, and patterns of health care use among enrollees.

  • With Medicare Open Enrollment Underway, Beneficiaries Typically Will Have a Choice of 43 Medicare Advantage Plans for 2024, Consistent with 2023 But More than Double The Number From 2018

    News Release

    With open enrollment underway, Medicare beneficiaries have until December 7th to review and select their coverage for 2024. They also have a lot of options to choose from, as two new KFF analyses show. For many beneficiaries, the first decision is whether to enroll in traditional Medicare (often with supplemental coverage and a stand-alone prescription drug plan) or Medicare Advantage, the private plans sponsored by insurance companies that now cover more than half of all…

  • Policy Landscape of Private Insurance Coverage of Contraception in the U.S.

    Issue Brief

    This issue brief explains the rules for private insurance coverage of contraceptives at the federal and state level, the exemptions and accommodations available for certain employers, gaps in coverage for contraceptives obtained outside of the traditional clinical setting, and how changes in the agencies responsible for making contraceptive recommendations may affect coverage for contraceptives.

  • I notice “short-term limited-duration” insurance plans for sale outside of the Marketplace, and they are cheaper than many other health plans. What is a short-term limited-duration health plan?

    FAQs

    “Short-term limited-duration” insurance plans are intended to fill a temporary gap in health coverage, such as when someone is between jobs. The maximum duration of short-term plans varies by state. Short-term plans must disclose to consumers that these plans are “NOT comprehensive health coverage.” Short-term plans often do not have the consumer protections found in Marketplace plans. For example, short-term plans can exclude coverage of pre-existing health conditions. Also, many short-term plans do not cover essential health…

  • Health Cost and Affordability Policy Issues and Trends to Watch in 2024

    Issue Brief

    While issues of health care costs and affordability may not be at the forefront of this year’s election issues, they remain a major concern among the public. About a quarter of Americans say they or a family member struggled to pay their medical bills just in the past year, and in recent KFF polling, voters said that health care affordability was very important to discuss in the election. This new issue brief describes the health…

  • The Affordable Care Act 101

    Feature

    This Health Policy 101 chapter provides an overview of the Affordable Care Act (ACA), a major reform of the U.S. health care system aimed at reducing high uninsured rates and alleviating issues like high out-of-pocket costs and coverage exclusions for preexisting conditions. The ACA significantly altered many aspects of the health system and the chapter explores its mechanisms, such as the Health Insurance Marketplaces, and the evolution of the law since its passage in 2010…