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Web Briefing for Journalists – ACA Cost-Sharing Subsidies: How One Decision Could Disrupt Obamacare Marketplaces

Premiums, insurer choice, and overall stability of 2018 Affordable Care Act (ACA) marketplaces could be affected by decisions from Congress and the Trump Administration on the health law’s cost-sharing reduction provision. With a legal appeal pending on a lawsuit from the U.S. House, the federal government and Congress are in…

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The Effects of Ending the Affordable Care Act’s Cost-Sharing Reduction Payments

This analysis estimates that total federal spending on Affordable Care Act marketplace subsidies would rise $2.3 billion, or 23 percent, in 2018 if payments for the cost-sharing reduction program were eliminated and insurers increased premiums to compensate. Established to reduce out-of-pocket costs for marketplace enrollees with lower incomes, the cost-sharing payments are being challenged in a lawsuit from the U.S. House.

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The Financial Burden of Health Care Spending: Larger for Medicare Households than for Non-Medicare Households

Medicare offers health and financial protection to nearly 60 million adults ages 65 and over and younger people with disabilities. However, the high cost of premiums, cost-sharing requirements, and gaps in the Medicare benefit package can result in beneficiaries devoting a substantial share of their total household spending to health care costs.This analysis compares health-related expenses as a share of total household spending for Medicare and non-Medicare households, using the 2016 Consumer Expenditure Survey. We estimate how much Medicare and non-Medicare households spent on health care, including premiums, compared to other household spending (e.g., housing, transportation, and food).

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Closing the Medicare Part D Coverage Gap: Trends, Recent Changes, and What’s Ahead

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.

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

  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…

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As Senate Weighs Bipartisan Stabilization Bill with Cost-Sharing Reduction Funding, Current Marketplace Enrollees Face Challenges with Affordability 

Knowledge and Awareness of Key Facts Regarding Enrollment Is Low As the Nov. 1 start of the Affordable Care Act’s open enrollment period nears, new polling data from the Kaiser Family Foundation finds that most potential enrollees are unaware of when they can enroll and have not seen any related…

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Medicare Advantage Plan Switching: Exception or Norm?

The Medicare open enrollment period allows enrollees to compare plans, stick with their current plan, switch to another plan, or shift to traditional Medicare. This analysis examines the extent to which Medicare Advantage enrollees change plans when given the opportunity. It also analyzes the variation in the rate of plan switching by enrollee and plan characteristics and whether people who voluntarily switch plans tend to move to plans with lower premiums, lower out-of-pocket limits, or higher quality ratings.

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Medicare Part D: A First Look at Prescription Drug Plans in 2017

This issue brief provides an overview of the 2017 Medicare Part D stand-alone prescription drug plan marketplace, based on analysis of data from the Centers for Medicare & Medicaid Services. The brief focuses on data for 2017 and changes over time in plan availability, premiums, benefit design, cost sharing, and low-income subsidy plan availability.

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50-State Survey of Medicaid Eligibility and Enrollment Policies in 2017: A Baseline for Measuring Future Changes

As the Trump administration and Republican leadership in Congress begin a new term and seek to repeal the Affordable Care Act (ACA), a new 50-state survey  from the Kaiser Family Foundation offers an in-depth profile of Medicaid and Children’s Health Insurance Program (CHIP) eligibility, enrollment, renewal, and cost sharing policies…

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Polling Data Note: Beyond the ACA, the Affordability of Insurance Has Been Deteriorating Since 2015

The debate about the future of the Affordable Care Act and its individual insurance marketplaces may be taking the focus off the affordability challenges facing the broader population, most of whom get their health coverage through employers, Medicare or Medicaid. New survey findings from the Kaiser Family Foundation show that…

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California.