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  • Health Costs Associated with Pregnancy, Childbirth, and Infant Care

    Issue Brief

    This analysis examines the health costs associated with pregnancy, childbirth, post-partum care, and infancy. It finds that health costs associated with pregnancy, childbirth, and post-partum care average a total of $20,416, including $2,743 in out-of-pocket expenses, for women enrolled in employer plans.

  • FAQs about the Inflation Reduction Act’s Medicare Drug Price Negotiation Program

    Issue Brief

    The Centers for Medicare & Medicaid Services (CMS) recently announced the drugs selected for the second round of negotiation for the Medicare Drug Price Negotiation Program, which was established by the Inflation Reduction Act. These FAQs address several questions related to Medicare’s drug price negotiation program and CMS's implementation of the program, with a focus on the details that apply for 2027, the second year that negotiated prices will be available under the program.

  • Changes to Medicare Part D in 2024 and 2025 Under the Inflation Reduction Act and How Enrollees Will Benefit

    Issue Brief

    The Inflation Reduction Act of 2022 includes several provisions to lower prescription drug costs for people with Medicare and reduce drug spending by the federal government, including a number of changes to the Medicare Part D drug benefit. This brief provides an overview of the Part D benefit design and Part D enrollee cost-sharing requirements in 2023 and changes coming in 2024 and 2025.

  • Coverage of Sexual and Reproductive Health Services in Medicare

    Issue Brief

    This brief describes Medicare coverage of sexual and reproductive health services, including contraception, and compares that coverage with private insurance plans and Medicaid. These benefits are particularly relevant to nearly 1 million women of reproductive age (20-49) who are eligible for Medicare due to having a long-term disability.

  • Explaining Cost-Sharing Reductions and Silver Loading in ACA Marketplaces

    Policy Watch

    The House of Representatives recently passed a budget reconciliation bill that would appropriate funding for cost-sharing reductions that insurers are required to provide to low-income enrollees in the Affordable Care Act marketplace. This policy watch explains what these cost-sharing reductions are, how they relate to federal spending, and what effect appropriating funding might have on premiums and the uninsured rate.

  • Make American Health Care Affordable Again

    Perspective

    In this JAMA Health Forum column, Larry Levitt highlights how the Make America Healthy Again agenda aimed at chronic disease does little to address the affordability of health care and that efforts to lower federal spending on health care may worsen the problem, raising out-of-pocket costs for many people with Medicaid and Affordable Care Act…

  • Medicare Advantage Has Become More Popular Among the Shrinking Share of Employers That Offer Retiree Health Benefits

    Issue Brief

    This analysis examines the extent to which large private and non-federal public employers that offer retiree health benefits are turning to Medicare Advantage and why they are making this shift, using data from the 2024 Employer Health Benefits Survey. We find that slightly more than half (56%) of large employers offering retiree health benefits to Medicare-age retirees offer coverage to at least some retirees through a contract with a Medicare Advantage plan, more than double the share in 2017 (26%).

  • Private Health Coverage of COVID-19: Key Facts and Issues

    Issue Brief

    New federal legislation will require most private health plans to cover testing for the coronavirus with no cost sharing. Some states have adopted similar requirements for insurers they regulate, and many private insurance companies will voluntarily expand coverage for testing. However, some private coverage will not be subject to these requirements. To date, fewer changes have been adopted or considered with respect to treatment for complications from the disease. This brief reviews current coverage standards for private health plans and how these may change in response to the COVID-19 pandemic.

  • Millions of Medicare Part D Enrollees Have Had Out-of-Pocket Drug Spending Above the Catastrophic Threshold Over Time

    Issue Brief

    Medicare Part D, the outpatient prescription drug benefit for Medicare beneficiaries, provides catastrophic coverage for high out-of-pocket drug costs, but there is no limit on the total amount that beneficiaries have to pay out of pocket each year. Policymakers on both sides of the aisle support proposals to modify the design of the Part D benefit and establish a hard cap on out-of-pocket prescription drug spending by Part D enrollees. This analysis shows the number of Part D enrollees without low-income subsidies who have exceeded the catastrophic coverage threshold annually, and over multiple years, based on 2007-2019 Part D claims data.