Cost Sharing - Research and Data from KFF

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.

How Medicare’s New Drug Price Negotiation Program Could Expand Access to Selected Drugs

Sep 26, 2023

Issue Brief

This brief examines how Part D enrollees’ access to and utilization of the first set of 10 selected drugs could be affected by the new Part D coverage and formulary requirements for selected drugs established by the Inflation Reduction Act and in CMS guidance, as well as the potential for lower out-of-pocket costs.

Key Facts About Medicare Part D Enrollment and Costs in 2023

Jul 26, 2023

Issue Brief

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 brief analyzes Medicare Part D enrollment and costs in 2023 and trends over time. The analysis highlights the substantial growth of Medicare Advantage drug plans in the marketplace for Part D drug coverage, where enrollment overall is concentrated in a handful of large plan sponsors.

Copay Adjustment Programs: What Are They and What Do They Mean for Consumers?

Oct 24, 2024

Issue Brief

Drug makers sometimes offer copay coupons to lower consumers’ out-of-pocket costs for their brand-name prescriptions, though how private health plans treat those coupons can substantially limit their value to consumers. This issue brief provides an overview of such copay adjustment programs, stakeholder arguments for and against their use, their prevalence, and federal and state efforts to address them.

No Surprises Act Implementation: What to Expect in 2022

Dec 10, 2021

Issue Brief

The “No Surprises Act,” which establishes new federal protections against most surprise out-of-network medical bills when a patient receives out-of-network services during an emergency visit or from a provider at an in-network hospital without advance notice, will take effect next month. A new KFF brief outlines what to expect in 2022.

KFF’s Kaiser Health News and NPR Launch Diagnosis: Debt, a Yearlong Reporting Partnership Exploring the Scale, Impact, and Causes of the Health Care Debt Crisis in America

Jun 16, 2022

News Release

KFF’s Kaiser Health News (KHN) and NPR today launched a yearlong investigative project that explores the scale, impact, and causes of the health care debt crisis in the United States.

Health Care Debt In The U.S.: The Broad Consequences Of Medical And Dental Bills

Jun 16, 2022

Report

The KFF Health Care Debt Survey finds that four in ten adults have some form of health care debt, with most citing one-time or short-term medical expenses as the contributor. Many of those with health care debt report making personal sacrifices and enduring financial consequences as a result of their debt, while nearly one in five think they will never be able to pay off.

Medicare Part D: A First Look at Medicare Drug Plans in 2023

Nov 10, 2022

Issue Brief

This issue brief provides an overview of the Medicare Part D marketplace in 2023 and key trends over time, focusing primarily on stand-alone Medicare drug plans, including plan availability, premiums, and cost sharing. The brief also describes the prescription drug provisions in the Inflation Reduction Act of 2022 that affect the Medicare Part D marketplace beginning in 2023

Interest in Using Over-the-Counter Oral Contraceptive Pills: Findings from the 2022 KFF Women’s Health Survey

Nov 3, 2022

Issue Brief

This brief presents data from the 2022 KFF Women’s Health Survey about reproductive age (18-49) females’ preferences for an over-the-counter contraceptive pill (N = 4,088).

The Implications of the Most Recent Challenge to the ACA’s Preventive Care Requirement Could Affect Millions

Oct 26, 2022

News Release

A new brief explains the implications of the most recent legal challenge contesting the Affordable Care Act’s (ACA) requirement that most private insurance plans cover specific preventive care items and services—such as contraceptive services and supplies, and cancer screenings—at no cost to patients. In Braidwood Management v.

Topics

Policy Research

Polling

Health News

Data & Features

For Media

About

Filter