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This issue brief examines states’ approaches to administering wrap-around benefits and cost-sharing in long-standing Medicaid premium assistance programs and the information available to beneficiaries about how to access these program features.
In 2018, three Medicare Part D plan sponsors—UnitedHealth, Humana, and CVS Health—account for more than half of the program’s 43 million Part D enrollees (55%) and two-thirds of all stand-alone drug plan enrollees, indicating a marketplace that is dominated by a handful of major insurers, according to a new Kaiser Family Foundation analysis of Part D enrollment, premiums and cost-sharing data. The proposed mergers of CVS Health and Aetna, and Cigna and Express Scripts would…
With congressional Republicans’ efforts to repeal the Affordable Care Act on hold, a new issue brief from the Kaiser Family Foundation answers questions about the current state of the 2010 health law, zeroing in on the individual insurance marketplaces that the law established. Questions addressed by the brief include: Is Obamacare failing? How would administrative actions affect market stability? What happens if the market fails? What might be done to strengthen the Marketplaces?
The October Kaiser Health Tracking Poll focuses on the Affordable Care Act’s (ACA) marketplaces as the November 1st open enrollment period approaches, amidst a period of uncertainty on the future of the individual market. The survey finds the majority of the public think it is more important for President Trump and Congress to work on legislation to stabilize the marketplaces rather than continue efforts to repeal and replace the ACA. A majority – across parties…
One million Medicare beneficiaries had out-of-pocket drug spending above the Part D catastrophic threshold in 2015, and the number with such high spending has risen sharply in recent years, according to a new analysis by the Kaiser Family Foundation. While the Part D drug benefit has helped make drugs more affordable for people with Medicare, the lack of a hard cap on annual out-of-pocket spending under Part D exposes enrollees to significant costs, unless they…
A new issue brief from the Kaiser Family Foundation reviews what the research shows about the effects of premiums and cost sharing on low-income populations in Medicaid and the Children’s Health Insurance Program (CHIP), drawing upon 65 peer-reviewed studies and government and research and policy organization reports and studies published between 2000 and March 2017. The review comes at a time when some state and federal policymakers have proposed allowing state Medicaid programs to charge…
Drew Altman looks at the numbers for COVID-19 treatment, and why it may soon be necessary for Congress to waive out-of-pocket costs for treatment.
The Institute of Medicine (IOM) recently issued its long-awaited report on defining the essential health benefits under the Affordable Care Act (ACA). As expected, the committee preparing the IOM report did not recommend which specific services should be covered, but rather discussed what the process should be for defining the essential benefits, which all insurers selling coverage to individuals and small businesses will have to provide beginning in 2014. Somewhat unexpected was their recommendation to set a…
The Department of Health and Human Services (HHS) recently released guidance on the two key components that determine the level of protection that private insurance plans will provide to consumers under health reform. The first involves the services that insurance plans must cover, and the second involves how much patients must pay out-of-pocket for those services. The Affordable Care Act (ACA) establishes new rules for what insurers must provide for both components starting in 2014.…
Standard Medicare Prescription Drug Benefit, 2013 Download Source Kaiser Family Foundation illustration based on CMS standard benefit parameter update for 2013. Amounts rounded to nearest dollar.
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