Cost Sharing - Research and Data from KFF

New Analysis Finds High Out-of-Pocket Spending Increased for People Covered by Large Employer Plans

Oct 5, 2017

News Release

A new Kaiser Family Foundation analysis finds about one in four people (24%) covered by large employer plans spent more than $1,000 out-of-pocket on health care in 2015, an increase of seven percentage points from 17 percent in 2005. About 1 in 10 people in such plans (12%) paid more than $2,000 out-of-pocket in 2015, a distribution that mirrors the distribution of overall health spending, according to the new analysis of claims data. Dollar…

Adding an Out-of-Pocket Spending Maximum to Medicare: Implementation Issues and Challenges

Feb 27, 2014

Issue Brief

In an effort to simplify Medicare’s cost-sharing requirements, provide beneficiaries with catastrophic protection, and achieve program savings, some have proposed to restructure Medicare’s benefit design. Several recent proposals would create a unified deductible for Medicare Parts A and B, simplify cost-sharing requirements above the deductible, and add an annual limit on beneficiary out-of-pocket spending—a benefit feature typical of larger employer plans, but lacking in traditional Medicare. This issue brief describes the options for adding an…

Family Health Premiums Rise 4 Percent to Average of $15,745 in 2012, National Benchmark Employer Survey Finds

Sep 11, 2012

News Release

Menlo Park, Calif. – Annual premiums for employer-sponsored family health coverage reached $15,745 this year, up 4 percent from last year, with workers on average paying $4,316 toward the cost of their coverage, according to the Kaiser Family Foundation/Health Research & Educational Trust (HRET) 2012 Employer Health Benefits Survey released today. This year’s premium increase is moderate by historical standards, but outpaced the growth in workers’ wages (1.7 percent) and general inflation (2.3 percent). Since…

A Polling Surprise? Americans Rank Unexpected Medical Bills at the Top of Family Budget Worries

Feb 28, 2020

News Release

When it comes to family budget concerns, unexpected medical bills top Americans’ list of worries, with two-thirds (65%) of the public saying they are at least somewhat worried, including 35% who say they are “very” worried, the latest KFF Health Tracking Poll finds. Fewer Americans say they are at least somewhat worried about seven other potential family expenses, including their health insurance deductible, transportation costs including gas, prescription drug costs, their rent or mortgage, their…

Despite ACA Changes, Silver Plan Deductibles for Low Incomes Steady Year-Over-Year

Dec 7, 2018

Feature

KFF analysis of Healthcare.gov data from marketplace plans on the federal insurance exchanges shows that despite the changes to the Affordable Care Act in recent years, deductibles for those with low incomes have remained relatively stable since 2017.

Tracking the Rise in Premium Contributions and Cost-Sharing for Families with Large Employer Coverage

Aug 15, 2019

Issue Brief

An analysis of large employer health coverage on the Peterson-Kaiser Health System Tracker finds that the cost to families for health coverage and care has risen more than two times faster than wages and three times faster than inflation over the last decade.

Abortion Coverage in the Bipartisan Health Care Stabilization Act of 2018 (S. 1771)

Mar 22, 2018

Issue Brief

This issue brief reviews current federal and state policies on private insurance coverage of abortion services, and how the Bipartisan Health Care Stabilization Act of 2018 would affect abortion coverage for women enrolled in the individual market.

An Analysis of the Share of Medicare Beneficiaries Who Would Benefit from an Annual Out-of-Pocket Maximum under Traditional Medicare Over Multiple Years

Jun 18, 2013

Issue Brief

This analysis examines the share of Medicare beneficiaries who would be helped over time if the program were to add a limit on out-of-pocket spending to traditional Medicare. This analysis was conducted jointly with the Medicare Payment Advisory Commission (MedPAC) in response to a request made during a Feb. 26, 2013 hearing of the House Ways and Means' Subcommittee on Health.

A Closer Look at North Carolina’s Implementation of the 2025 Reconciliation Law Medicaid Provisions and Other Changes Amid Medicaid Budget Shortfalls

May 29, 2026

Policy Watch

This policy watch provides initial insight into how North Carolina is preparing to implement certain Medicaid provisions of the 2025 reconciliation law and how other policy changes may affect coverage and access to care.

Understanding Medicaid Cost Sharing and Policy Changes from the 2025 Reconciliation Law

May 21, 2026

Issue Brief

This brief explains current Medicaid cost sharing rules and changes made to cost sharing rules by the 2025 reconciliation law, reports on cost sharing amounts states currently impose on ACA expansion adults, and highlights literature on the impact of cost sharing.

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