Cost Sharing - Research and Data from KFF

Constrained Budgets Lead States to Restrict HIV Drug Access Through Ryan White

Mar 2, 2026

Policy Watch

States are facing constrained budgets, putting pressure on HIV programs, including the Ryan White HIV/AIDS Program. This Policy Watch explores how state Ryan White AIDS Drug Assistance Programs (ADAPs) are responding to these budget pressures, including by restricting eligibility and reducing the scope of services offered, actions that could led to negative health outcomes for people with HIV and lead to new HIV infections.

How Recent Manufacturer Savings Programs May Impact Individual Out-of-Pocket Spending on Asthma and COPD Inhalers

Aug 11, 2025

Issue Brief

A new analysis shows that individuals with employer insurance could save 41% on their out-of-pocket spending for asthma and COPD inhalers through manufacturer savings. In response to a U.S. Senate investigation into inhaler costs, 3 drug makers voluntarily capped out-of-pocket costs on their brand-name asthma and COPD inhalers.

Use of ACA preventive services potentially affected by Braidwood v. Becerra

May 25, 2023

Issue Brief

This analysis finds that about 10 million privately insured people received at least one ACA preventive service or drug that could be affected by a now-stayed U.S. District Court ruling, which found the Affordable Care Act's (ACA) requirement to cover certain preventive services without any cost sharing to be partially unconstitutional.

Lower Income Adults with Employer Sponsored Insurance Face Unique Challenges with Coverage Compared to Higher Income Adults

Dec 19, 2023

Issue Brief

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.

What are the Consequences of Health Care Debt Among Older Adults?

Jul 26, 2024

Issue Brief

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 health care debt among Medicare-age adults.

Medicare Part D 2010 Data Spotlight: Benefit Design and Cost Sharing

Nov 30, 2009

Report

The Medicare Modernization Act established a defined standard drug benefit for Part D stand-alone Prescription Drug Plans (PDPs) and Medicare Advantage Prescription Drug (MA-PD) plans, while giving plans flexibility to offer alternative benefit designs. Only about one in 10 PDPs offer the standard benefit in 2010.

Medicare Part D Data Spotlight: A First Look at Part D Plan Offerings in 2012

Sep 30, 2011

Report

This data spotlight examines the stand-alone Part D drug plan options available to Medicare beneficiaries in 2012. Medicare beneficiaries will, on average, be able to choose from 31 stand-alone Medicare Part D prescription drug plans to choose from, a new Kaiser analysis finds.

Oral Health and Medicare Beneficiaries: Coverage, Out-of-Pocket Spending, and Unmet Need

Jun 19, 2012

Issue Brief

This brief describes the oral health of Medicare beneficiaries, examines sources of dental coverage for the Medicare population, and examines the utilization of dental services, out-of-pocket spending on dental care, and access problems.

Restructuring Medicare’s Benefit Design: Implications for Beneficiaries and Spending

Oct 31, 2011

Report

Several deficit-reduction plans have proposed combining Medicare's separate deductibles for hospital and physician services, standardizing cost sharing across types of benefits, and establishing a new limit on annual out-of-pocket costs for beneficiaries.

Average Annual Premiums for Family Health Benefits Top $15,000 in 2011, Up 9 Percent, Substantially More than the Growth in Worker’s Wages, Benchmark Employer Survey Finds

Sep 27, 2011

News Release

NEWS RELEASESeptember 27, 2011 Average Annual Premiums for Family Health Benefits Top $15,000 in 2011, Up 9 Percent, Substantially More than the Growth in Worker’s Wages, Benchmark Employer Survey FindsAbout 2.

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