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This issue brief provides an overview of Medicare, the health insurance program for people ages 65 and over and younger people with long-term disabilities. The brief review the characteristics of people on Medicare, what Medicare covers, benefit gaps and supplemental coverage, beneficiaries' out-of-pocket health care spending, program spending and financing, payment and delivery system reform, and issues for the future of Medicare.
The Affordable Care Act (ACA) requires most private health insurance plans to provide coverage for a broad range of preventive services including Food and Drug Administration (FDA) approved prescription contraceptives and services for women. Since the implementation of the ACA contraceptive coverage requirement in 2012, over 200 corporations have filed lawsuits claiming that including coverage for contraceptives or opting for an “accommodation” from the federal government violates their religious beliefs. This brief explains the legal issues raised by the nonprofit litigation and discusses the impact of the Hobby Lobby decision on the current litigation.
The survey is the second in a series exploring the experiences and perceptions of people who purchase their own health insurance, the group perhaps most affected by the Affordable Care Act's reforms to the individual insurance market and tax subsidies to make such coverage more affordable. It includes people in ACA-compliant plans sold both inside and outside the federal and state marketplaces, as well as those still in non-compliant plans, which took effect prior to January 2014 and in many cases do not comply with all the law’s requirements.
This issue brief explains how behavioral health parity applies in the Medicaid program, including the major provisions of the Centers for Medicare and Medicaid Services’ (CMS) April 10, 2015 proposed regulations, and identifies key policy issues at the intersection of behavioral health parity and Medicaid.
This data note examines the latest data and trends in the Medicare Part D coverage gap, where enrollees must pay a greater share of their prescription drug costs. The note includes data about how many Part D enrollees reached the coverage gap, their average out-of-pocket spending, the value of manufacturer discounts, and recent and proposed changes affecting out-of-pocket costs for Part D enrollees who reach the gap.
In 2018, three Medicare Part D plan sponsors—UnitedHealth, Humana, and CVS Health—account for more than half of the program’s 43 million Part D enrollees (55%) and two-thirds of all stand-alone drug plan enrollees, indicating a marketplace that is dominated by a handful of major insurers, according to a new Kaiser Family Foundation analysis of Part…
Note: This content was updated on February 28, 2024 to incorporate new FAQs from CMS. Tables 1 and 2 were also updated to include updated recommendations. It has been more than ten years since the Affordable Care Act (ACA) required private insurance plans to cover recommended preventive services without any patient cost-sharing.
A new issue brief from the Kaiser Family Foundation reviews what the research shows about the effects of premiums and cost sharing on low-income populations in Medicaid and the Children’s Health Insurance Program (CHIP), drawing upon 65 peer-reviewed studies and government and research and policy organization reports and studies published between 2000 and March 2017.
This issue brief provides an overview of the 2018 Medicare Part D stand-alone prescription drug plan landscape, the largest segment of the Part D marketplace, 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 top ten Part D plans in 2018.
The October Kaiser Health Tracking Poll focuses on the Affordable Care Act’s (ACA) marketplaces as the November 1st open enrollment period approaches, amidst a period of uncertainty on the future of the individual market. The survey finds the majority of the public think it is more important for President Trump and Congress to work on legislation to stabilize the marketplaces rather than continue efforts to repeal and replace the ACA. A majority – across parties – also support a bipartisan compromise that includes Congress guaranteeing cost-sharing reduction (CSR) payments to insurance companies.
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