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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…
The Alliance for Health Reform and the Kaiser Family Foundation present a briefing to discuss the basics of Medicaid and its role in the health care system. Speakers address questions on how the program is administered, how much it costs and how it is financed, as well as how the Affordable Care Act affects the program and what states are doing to transform Medicaid to meet current and future needs of its beneficiaries. For more…
This issue brief provides an overview of the Medicare Part D prescription drug benefit market for 2022, with a primary focus on stand-alone drug plans. It includes national and state-level data on plan availability, premiums, benefit design, cost sharing, information about premium-free plans for low-income beneficiaries, and information about the national Part D drug plans available in 2022.
In a commentary on KFF’s 27th employer health benefits survey, President and CEO Dr. Drew Altman discusses the obstacles employers face trying to control their health care costs, and the reasons why they’ve never been meaningful supporters of government cost-containment efforts. He predicts that premium increases expected next year could lead to a new wave of higher deductibles and other forms of cost sharing for the 155 million Americans who rely on employer coverage. Read…
This analysis examines the experiences of lower income adults with their employer sponsored insurance and finds they were more likely to self-report problems with affordability, enrollment, and network adequacy, and to experience negative health consequences as a result of insurance problems, compared to their higher income peers.
Health care debt is a widespread problem in the United States. Medicare offers coverage for a range of health care services, including hospitalizations, physician visits, prescription drugs, and post-acute care, but Medicare beneficiaries generally pay out-of-pocket for their monthly premiums and deductibles, cost-sharing for Medicare-covered services, and the cost of services not covered by Medicare. This data note examines findings from the KFF Health Care Debt Survey to assess the prevalence, sources and consequences of…
In February, the Trump administration launched TrumpRx, a government website that provides prescription drug discounts to consumers. This brief examines issues that may impact consumers, especially those with private insurance, who access drug discounts through TrumpRx.
This analysis documents average deductibles for Affordable Care Act Marketplace plans available on Healthcare.gov in 2026 for all metal tiers, including silver plans after cost-sharing reductions are applied, as well as trend data since 2014.
In this column for The Wall Street Journal’s Think Tank, Drew Altman discusses new Foundation survey findings showing that most consumers see their high deductible health plans as a bad value.
In light of heightened attention to insulin and the Trump Administration’s new Part D model to address out-of-pocket costs for insulin for Medicare beneficiaries, we analyzed out-of-pocket spending on insulin by beneficiaries enrolled in Part D drug plans, variation in Part D plan formulary coverage and tier placement of insulin products, and trends in prices for insulin.
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