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Medicare Part B Drugs: Cost Implications for Beneficiaries in Traditional Medicare and Medicare Advantage

Mar 15, 2022

Issue Brief

In the face of rising prescription drug costs, a large majority of the public supports federal efforts to lower drug spending. Policymakers are considering several proposals that would lower prescription drug costs. To better understand the potential out-of-pocket cost exposure that Medicare beneficiaries may face for Part B drugs, which are typically administered by physicians and other health care providers, we analyzed cost-sharing liability for these drugs in traditional Medicare and cost-sharing requirements in Medicare…

Fate of Medicaid Expansion and Filling the Coverage Gap May Once Again Depend on the Outcome of State Elections

Aug 17, 2022

Policy Watch

This post examines the potential for this year's midterm elections to decide the fate of Medicaid expansion, with gubernatorial races in 10 of the 12 states that have not expanded, including Georgia, Kansas and Wisconsin, where the gubernatorial race is considered a toss-up. South Dakota voters also will decide a Medicaid expansion ballot initiative.

Selected Out-of-Pocket Costs as a Share of the Average Social Security Benefit

Apr 29, 2022

Feature

Medicare premiums and cost sharing will account for an increasing share of Social Security benefits in the future, Medicare Trustees project.

Medicaid Coverage of Behavioral Health Services in 2022: Findings from a Survey of State Medicaid Programs

Mar 17, 2023

Issue Brief

To better understand the variation in access to behavioral health services for adults in Medicaid, KFF surveyed state Medicaid officials about behavioral health benefits covered for adult enrollees in their fee-for-service programs.

2024 Employer Health Benefits Chart Pack

Oct 9, 2024

Feature

This slideshow captures key data from the 2024 KFF Employer Health Benefits Survey survey, providing a detailed look at trends in employer-sponsored health coverage, including premiums, employee contributions, cost-sharing, abortion coverage, offer rates, wellness programs, and other employer practices.

Strategies to Manage Unwinding Uncertainty for Medicaid Managed Care Plans: Medical Loss Ratios, Risk Corridors, and Rate Amendments

Apr 10, 2023

Issue Brief

This brief provides a high-level snapshot of states with minimum medical loss ratio (MLR) and remittance requirements and risk corridors in place as of July 1, 2022 that may provide financial protection and limits on financial risk for states and plans as the unwinding unfolds.

How the Pandemic Continues to Shape Medicaid Priorities: Results from an Annual Medicaid Budget Survey for State Fiscal Years 2022 and 2023

Oct 25, 2022

Report

This report provides an in-depth examination of the changes taking place in Medicaid programs across the country. The findings are drawn from the 22nd annual budget survey of Medicaid officials conducted by KFF and Health Management Associates (HMA), in collaboration with the National Association of Medicaid Directors (NAMD). This report highlights policies in place in state Medicaid programs in FY 2022 as well as policy changes implemented or planned for FY 2022.

KFF graphic featuring a quote from Juliette Cubanski, KFF Deputy Director of the Program on Medicare Policy. It says, “CMS’s efforts to expand Medicare coverage of GLP-1s for obesity could provide substantial benefits to millions of Medicare beneficiaries, given the potential demand for these highly effective medications…There are potential drawbacks to the short-term program, however.”

What Medicare’s Temporary Program Covering GLP-1s for Obesity Means for Beneficiaries

Mar 9, 2026

Quick Insights

CMS’s efforts to expand Medicare coverage of GLP-1s for obesity could provide substantial benefits to millions of Medicare beneficiaries, given the potential demand for these highly effective medications…There are potential drawbacks to the short-term program, however.

CMS Prior Authorization Proposal Aims to Streamline the Process and Improve Transparency

Feb 21, 2023

Issue Brief

This brief explains a new proposed federal regulation aimed at reducing administrative hassles involved in obtaining prior authorization for care and sets out key policy questions, including how the proposal could impact the patient experience and data privacy.

KFF Health Tracking Poll July 2022: Inflation Tops Voters’ Priorities, But Abortion Access Resonates For Key Voting Blocs

Aug 2, 2022

Feature

This poll finds most voters (55%) now say access to abortion is “very important” to their vote in November’s midterm elections, up since the Supreme Court decision overturning Roe v. Wade. This heightened interest is greatest among voter groups who largely want to guarantee access to abortion, including Democratic voters and women voters under 50 years old.

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