Cost Sharing - Research and Data from KFF

Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost Sharing Policies as of January 2017: Findings from a 50-State Survey

Jan 12, 2017

Report

This 15th annual 50-state survey provides data on Medicaid and Children’s Health Insurance Program (CHIP) eligibility, enrollment, renewal and cost sharing policies as of January 2017, and identifies changes in these policies in the past year. As discussion of repeal of the Affordable Care Act (ACA), broader changes to Medicaid, and reauthorization of CHIP unfolds, this report documents the role Medicaid and CHIP play for low-income children and families and the evolution of these programs under the ACA. The findings offer an in-depth profile of eligibility, enrollment, renewal, and cost sharing policies in each state as of January 2017, providing a baseline against which future policy changes may be measured.

What Might a Repeal of the Affordable Care Act Mean for Medicare?

Dec 13, 2016

News Release

As Republican policymakers consider how to repeal and replace the Affordable Care Act (ACA), they are likely to face a number of decisions about whether to retain any of the law’s changes to Medicare. Repealing the ACA has potential implications for Medicare spending, beneficiaries, and other stakeholders, according to a new Kaiser Family Foundation brief.

What Are the Implications of Repealing the Affordable Care Act for Medicare Spending and Beneficiaries?

Dec 13, 2016

Issue Brief

The 2010 Affordable Care Act (ACA) included many provisions affecting the Medicare program and the 57 million seniors and people with disabilities who rely on Medicare for their health insurance coverage. This brief explains the Medicare provisions in the ACA and explores the implications for Medicare and beneficiaries of repealing these provisions.

New Analysis Finds Out-of-Pocket Prescription Drug Spending Decreasing on Average, But More People Spending in Excess of $1,000 a Year

Oct 28, 2016

News Release

A new Kaiser Family Foundation analysis finds that average annual out-of-pocket prescription drug spending for workers and family members decreased from a recent high of $167 in 2009 to $144 in 2014.

One Million Medicare Part D Enrollees Had Out-of-Pocket Drug Costs above the Catastrophic Threshold in 2015

Nov 7, 2017

News Release

One million Medicare beneficiaries had out-of-pocket drug spending above the Part D catastrophic threshold in 2015, and the number with such high spending has risen sharply in recent years, according to a new analysis by the Kaiser Family Foundation.

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.

Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost Sharing Policies as of January 2018: Findings from a 50-State Survey

Mar 21, 2018

Report

This 16th annual 50-state survey provides data on Medicaid and the Children’s Health Insurance Program (CHIP) eligibility, enrollment, renewal and cost sharing policies as of January 2018. It takes stock of how the programs have evolved as the fifth year of implementation of the Affordable Care Act (ACA) begins, discusses policy changes made during 2017, and looks ahead to issues that may affect state policies moving forward. It is based on a survey of state Medicaid and CHIP officials conducted by the Kaiser Family Foundation and the Georgetown University Center for Children and Families. State data are available in Appendix Tables 1-20.

Insulin Costs and Coverage in Medicare Part D

Jun 4, 2020

Issue Brief

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.

The ‘Private Option’ Medicaid Expansion in Arkansas Has Helped Reduce the Uninsured Rate and Uncompensated Care Costs While Boosting the State’s ACA Marketplace

Aug 26, 2015

News Release

A new issue brief from the Kaiser Family Foundation finds that Arkansas’ “private option” Medicaid expansion has helped reduce the number of uninsured and bring down uncompensated care costs while strengthening the state’s ACA marketplace.

Patient Cost-Sharing in Marketplace Plans, 2016

Nov 13, 2015

Issue Brief

This brief and accompanying slides examine cost sharing - deductibles, copayments and coinsurance - in 2016 insurance plans sold on the Affordable Care Act's (ACA) federally-facilitated marketplaces. The analysis looks at out-of-pocket limits, as well as cost sharing for hospital stays, physician visits, emergency room visits, and prescription drugs, for plans across the metal levels (platinum, gold, silver and bronze).

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