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This analysis of government data finds that people with medical debt are much more likely to have other forms of financial distress than those without medical debt, like having no “rainy day” fund, overdrawing a checking account, or relying on costly loans.
A new federal law provides new consumer protections against "surprise" medical bills beginning this year. Test your knowledge about its provisions with this 12-question quiz.
In this commentary for Barron's, Cynthia Cox explores the impact to the American public as the U.S. health insurance system adjusts to the COVID-19 pandemic. She uses the experience of the past year and a half to raise questions about broader issues of fairness in the distribution of health care costs in the country.
Our review of recent literature on premiums and cost-sharing is based on studies and reports published between 2017 and 2021. Our analysis of premiums in post-Affordable Care Act (ACA) Section 1115 waivers (approved under the Obama and Trump administrations) is based on available interim and final waiver evaluations as well as annual and quarterly state data reports posted on Medicaid.gov.
Medicare Part D, the outpatient prescription drug benefit for Medicare beneficiaries, provides coverage above a catastrophic threshold for high out-of-pocket drug costs, but there is no cap on total out-of-pocket drug costs that beneficiaries pay each year. Recent legislative proposals would add a cap on out-of-pocket spending under Part D. This analysis focuses on the potential impact of different out-of-pocket spending caps in terms of how many beneficiaries would be affected and how much they could save.
This annual survey of employers provides a detailed look at trends in employer-sponsored health coverage, including premiums, worker contributions, cost-sharing provisions, offer rates, and more. This year's report also looks at how employers are approaching coverage of GLP-1 drugs for weight loss, including their concerns about utilization and cost.
This brief provides an overview of the role of PBMs in managing pharmacy benefits, discusses recent federal legislation focusing on several elements of PBM business practices, and explains the potential federal budgetary impact of this legislation, which would have a relatively modest impact on the federal deficit, based on available CBO estimates.
This brief provides an overview of premiums and benefits in Medicare Advantage plans that are available for 2026 and key trends over time.
This analysis examines access to, and consumers ability to find information on, a new twice annual long-acting PrEP drug during the first ACA open enrollment period since its approval. Despite the drug widely being considered a major advance, early evidence suggests that insurance coverage and benefit design decisions may create barriers to access.
To document the affordability challenges posed by out-of-pocket health care costs for people with Medicare, this brief analyzes out-of-pocket health care costs as a share of Social Security income and total income, including other sources of income in addition to Social Security.
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