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  • Key Issues in Understanding the Economic and Health Security of Current and Future Generations of Seniors

    Issue Brief

    As part of broad deficit-reduction plans, policymakers are considering reforms to the nation's three major entitlement programs - Medicare, Medicaid and Social Security - that could significantly affect the economic security of seniors in their retirement years. This brief examines the role of these programs in ensuring seniors' financial security as well as the challenges facing current and future generations when it comes to economic and health security. Drawing from current research and data, the…

  • Medicare Part D: A First Look at Part D Plan Offerings in 2013

    Report

    This data spotlight examines the stand-alone Part D drug plan options available to Medicare beneficiaries in 2013 during the open enrollment period, which runs from October 15 to December 7, 2012. The analysis is the first in a series of planned reports examining the private plan choices available to Medicare beneficiaries for 2013. It is authored by Jack Hoadley and Laura Summer of Georgetown University, Juliette Cubanski and Jennifer Huang of the Kaiser Family Foundation,…

  • Medicare Cost-Sharing: Implications for Beneficiaries

    Event Date:
    Event

    Tricia Neuman, Vice President and Director of the Medicare Policy Project, testified on behalf of herself and Thomas Rice, Ph.D., of UCLA's School of Public Health, before the House Ways and Means Subcommittee on Health on cost-sharing requirements under Medicare and supplemental Medigap policies. The statement reviews Medicare beneficiaries' current cost-sharing responsibilities, the evidence on the impact of out-of-pocket costs on health-care utilization, and the implications for proposals that would modify Medicare's cost-sharing structure.

  • What the Actuarial Values in the Affordable Care Act Mean

    Issue Brief

    The Patient Protection and Affordable Care Act (PPACA) establishes four levels of coverage based on the concept of "actuarial value," which represents the share of health care expenses the plan covers for a typical group of enrollees. As plans increase in actuarial value – bronze, silver, gold, and platinum – they would cover a greater share of enrollees' medical expenses overall, though the details could vary across plans. The levels of coverage provided for in…

  • Medicare Prescription Drug Plans in 2009 and Key Changes Since 2006: Summary of Findings

    Issue Brief

    Since 2006, Medicare beneficiaries have had access to prescription drug coverage offered by private plans, either stand-alone prescription drug plans (PDPs) or Medicare Advantage prescription drug plans (MA-PD plans). Today, more than 26 million Medicare beneficiaries are enrolled in Medicare drug plans, including 17.5 million in stand-alone prescription drug plans and 9 million in Medicare Advantage drug plans. This report summarizes findings from a series of Medicare Part D 2009 Data Spotlights documenting changes in…

  • Questions About Essential Health Benefits

    Perspective

    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 Budget Trigger and Health Reform

    Perspective

    No doubt it will take some time to sort out how elements of the debt deal (formally "The Budget Control Act of 2011") will all work. Delving into the details of how it affects subsidies in the Affordable Care Act (ACA) to make insurance more affordable helps to illustrate how complex this business can be. Let's start with a short primer on the ACA subsidies. Starting in 2014 people buying insurance on their own in…

  • Betting on Private Insurers

    Perspective

    Just-released estimates of national health spending in 2010 by the Centers for Medicare and Medicaid Services (CMS) show that 45% of our health care spending is financed by the federal and state governments, primarily through the Medicare and Medicaid programs. This share has grown temporarily in recent years because of the economic downturn, as private insurance has declined and Medicaid has grown. It has also increased due to our demographic destiny: the growing cohort of baby…

  • Transparency and Complexity

    Perspective

    This fall a new rule takes effect requiring all private health plans to offer a uniform, simple to read, summary of benefits and coverage (SBC).  The SBC will provide consumers with standardized information about how plans cover essential health benefits and what coverage limits and cost sharing applies. The SBC is one of the most popular provisions of the ACA.  Consumers often find health insurance difficult to understand and would no doubt welcome a plainly written…

  • How High Drug Prices Weigh on the Sickest Americans

    From Drew Altman

    In this column for The Wall Street Journal's Think Tank, Drew Altman explores the data behind public concern about prescription drug costs and highlights that the people most in need are the most burdened by the problem.