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Medicaid Changes in House and Senate Reconciliation Bills Would Increase Costs for 1.3 Million Low-Income Medicare Beneficiaries

Jun 17, 2025

Issue Brief

On May 22, the House passed a reconciliation bill, the One Big Beautiful Bill Act, which would partially pay to extend expiring tax cuts by cutting Medicaid. The Congressional Budget Office (CBO) estimates that the bill would reduce federal Medicaid spending by $793 billion over ten years and 10.3 million fewer people would be enrolled in Medicaid in 2034, including 1.3 million people with Medicare, otherwise known as “dual-eligible individuals”.

Moving the Needle on Prescription Drug Costs: Using the Innovation Center and Other Demonstration Authority

Mar 25, 2021

Issue Brief

This brief examines how the CMS Innovation Center (also known as CMMI) and Section 402 demonstration authority could become pathways for the Biden Administration to implement policy changes related to prescription drug costs.

What Drives Health Spending in the U.S. Compared to Other Countries

Aug 2, 2024

Issue Brief

An updated issue brief looks at the drivers of health spending in the U.S. and key differences between the U.S. and other large, wealthy nations. The analysis finds that people in the U.S. spent $5,683 more per person on health care compared to those in similarly large and wealthy countries.

2025 Medicare Advantage Plan Choices are Stable, Following Years of Steady Growth

Oct 15, 2024

Policy Watch

A review of the 2025 Medicare Advantage plans available for individual enrollment shows that the total number of plans declined by 7% (from 3,959 to 3,699). The average Medicare beneficiary will have the option of 34 Medicare Advantage prescription drug (MA-PD) plans in 2025, just 2 fewer than the 36 options available in 2024. Since 2018, the number of plans available to the average beneficiary has doubled.

After Pandemic-Era Policies and Enhanced Funding End, State Medicaid Officials Report Enrollment Declines and Upward Cost Pressures

Oct 23, 2024

News Release

States expect national Medicaid enrollment to decline by about 4% and state Medicaid spending to rise by 7% in fiscal year (FY) 2025.

5 Questions About the Idea of Default Enrollment into Medicare Advantage Plans

Apr 29, 2025

Issue Brief

This brief considers how default enrollment into Medicare Advantage might work, potential challenges with this approach, and implications for beneficiaries, insurers, providers, agents and brokers, and the federal budget.

Cost Sharing Requirements Could Have Implications for Medicaid Expansion Enrollees With Higher Health Care Needs

Jun 27, 2025

Issue Brief

This brief uses 2021 Medicaid claims data to examine utilization among Medicaid expansion adults and estimate how much cost sharing these enrollees could be required to pay under the new requirement if all states imposed the maximum cost sharing amounts. This is an illustrative analysis intended to describe which enrollees may be subject to the most cost sharing under the new provisions rather than estimate exactly what expansion enrollees may actually pay.

The Effect of Delaying the Selection of Small Molecule Drugs for Medicare Drug Price Negotiation

Apr 16, 2025

Policy Watch

In a new Trump administration executive order, the Secretary of HHS is directed to work with Congress to implement a change in law to delay negotiation of so-called “small molecule” drugs under the Inflation Reduction Act's Medicare Drug Price Negotiation Program for an additional 4 years. This brief analyzes how many of the drugs previously selected for negotiation would not have been eligible if this policy had been in place at the time.

Medicare Part D Premiums Are Increasing for Many But Not All Stand-Alone Plans in 2025, Reflecting Effects of New Premium Stabilization Demonstration

Oct 3, 2024

Policy Watch

This policy watch examines monthly premiums for Medicare Part D stand-alone drug plans in 2025, as changes to the Part D benefit are being implemented in 2025, including a new $2,000 cap on out-of-pocket drug spending.

Medicare Advantage in 2025: Premiums, Out-of-Pocket Limits, Supplemental Benefits, and Prior Authorization

Jul 28, 2025

Issue Brief

This brief provides information about Medicare Advantage plans in 2025, including premiums, out-of-pocket limits, supplemental benefits, and prior authorization, as well as trends over time.

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