This interactive map shows the status of all Section 1332 waivers requested by states. The Affordable Care Act (ACA) allows states to apply for innovation waivers to alter key ACA requirements in the individual and small group insurance markets and can be used to shore up fragile insurance markets, address unique state insurance market issues, or experiment with alternative models of providing coverage to state residents.
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New Analysis of Large Employer Health Coverage: The Cost to Families for Health Coverage and Care Has Risen More Than 2X Faster Than Wages and 3X Faster Than Inflation Over the Last Decade
A new KFF analysis that looked at both premiums and other out-of-pocket costs shows that families with coverage through a large employer paid 67 percent more for their health benefits and care in 2018 than a decade earlier. In 2018, a typical family of four with large employer coverage spent…
Tracking the Rise in Premium Contributions and Cost-Sharing for Families with Large Employer Coverage
An analysis of large employer health coverage on the Peterson-Kaiser Health System Tracker finds that the cost to families for health coverage and care has risen more than two times faster than wages and three times faster than inflation over the last decade.
The Medicare Part D prescription drug benefit has helped improve the affordability of medications for people with Medicare. Yet Part D enrollees can face relatively high out-of-pocket costs because the Part D benefit does not have a hard cap on out-of-pocket spending. This analysis presents the latest data on out-of-pocket drug spending among Medicare Part D enrollees without low-income subsidies who have costs above the catastrophic coverage threshold.
In roughly 1 of every 6 emergency room visits and inpatient hospital stays in 2017, patients came home with at least one out-of-network medical bill, a new KFF analysis finds. More specifically, 18 percent of all emergency visits and 16 percent of in-network hospital stays had at least one out-of-network…
This analysis examines how often patients get hit with surprise medical bills, what circumstances tend to give rise to them and what proposals are being considered to protect consumers from this problem.
The Medicare Part D program provides an outpatient prescription drug benefit to older adults and people with long-term disabilities in Medicare who enroll in private plans. This analysis provides the latest data about Medicare Part D coverage and costs in 2019 and trends over time, including enrollment, premiums, cost sharing, and participation in the low-income subsidy program.
The analysis finds that people who switched from traditional Medicare to Medicare Advantage in 2016 had health spending in 2015 that was $1,253 less, on average, than the average spending for beneficiaries who remained in traditional Medicare (after adjusting for health risk). The findings suggest that the current payment method may systematically overestimate expected costs of Medicare Advantage enrollees. Adjusting payments to reflect Medicare Advantage enrollees’ prior use of health services could potentially lower total Medicare spending by billions of dollars over a decade.
Medicaid and CHIP Eligibility, Enrollment, and Cost Sharing Policies as of January 2019: Findings from a 50-State Survey
This 17th annual survey of the 50 states and the District of Columbia (DC) provides data on Medicaid and the Children’s Health Insurance Program (CHIP) eligibility, enrollment, renewal, and cost sharing policies as of January 2019.
This issue brief provides an overview of Medicare, the health insurance program for people ages 65 and over and younger people with long-term disabilities. The brief review the characteristics of people on Medicare, what Medicare covers, benefit gaps and supplemental coverage, beneficiaries’ out-of-pocket health care spending, program spending and financing, payment and delivery system reform, and issues for the future of Medicare.