Cost Sharing - Research and Data from KFF

As the Courts Weigh the Future of the ACA’s Preventive Services Coverage, a New Analysis Shows that Most People with Private Insurance Received At Least One of Those Benefits in 2018

Mar 20, 2023

News Release

The provision of the Affordable Care Act (ACA) that requires most private health plans to cover many preventive services without any cost-sharing for their enrollees is being challenged in federal court. The U.S. District Court in the Northern District of Texas in September concluded that aspects of the requirement were unconstitutional and violated religious rights but has allowed the provision to remain in effect while it considers a remedy. As the courts consider the ACA’s…

Preventive Services Use Among People with Private Insurance Coverage

Mar 20, 2023

Issue Brief

This analysis of claims data estimates that six in ten people with private health insurance - or about 100 million people - used at least one preventive service covered without any out-of-pocket costs through a provision of the Affordable Care Act (ACA) in a typical year prior to the COVID-19 pandemic (2018). The provision that requires most private health plans to cover many preventive services without any cost-sharing for their enrollees is being challenged in…

Many Women Use Preventive Services, but Gaps in Awareness of Insurance Coverage Requirements Persist: Findings from the 2022 KFF Women’s Health Survey

Feb 22, 2023

Issue Brief

This brief presents findings from the 2022 KFF Women’s Health Survey on women’s receipt of cancer screenings and other preventive services and differences between subgroups of women. We also present data on women’s and men’s awareness of federal requirements for private insurance coverage of preventive services.

The Commercialization of Covid Vaccines Is Coming. Here’s What It Means.

Feb 18, 2023

Perspective

In this commentary for Barron's, KFF's Cynthia Cox and Jennifer Kates explore what will happen with costs to COVID-19 vaccines for people with and without insurance once the relevant public health emergency ends on May 11.

The End of the COVID-19 Public Health Emergency: Details on Health Coverage and Access

Feb 3, 2023

Policy Watch

This post provides an overview of how health care coverage and access will and won’t change when the public health emergency ends on May 11, including a discussion of COVID-19 vaccines, tests, and treatments, and telemedicine.

What Happens When COVID-19 Emergency Declarations End? Implications for Coverage, Costs, and Access

Jan 31, 2023

Issue Brief

This brief provides an overview of the major health-related COVID-19 federal emergency declarations that have been made since early on in the pandemic, summarizes the flexibilities triggered by each, and identifies the implications for their ending, related to coverage, costs, and payment for COVID-19 testing, treatments, and vaccines; Medicaid coverage and federal match rates; telehealth; access to medical countermeasures through FDA emergency use authorization (EUA); and other Medicaid, Medicare and private health insurance flexibilities.

How Will the Prescription Drug Provisions in the Inflation Reduction Act Affect Medicare Beneficiaries?

Jan 24, 2023

Issue Brief

The brief provides a quick explainer of the prescription drug provisions in the Inflation Reduction Act signed into law on August 16, 2022 and presents new estimates on how many Medicare beneficiaries could be helped by those provisions.

Explaining the Prescription Drug Provisions in the Inflation Reduction Act

Jan 24, 2023

Issue Brief

The Inflation Reduction Act includes several provisions that will lower prescription drug costs for people with Medicare and reduce drug spending by the federal government. This brief summarizes these provisions and discusses the expected effects on people, program spending, and drug prices and innovation.

FAQs on Mental Health and Substance Use Disorder Coverage in Medicare

Jan 18, 2023

Issue Brief

These FAQs review mental health and substance use disorder coverage and cost sharing in Medicare and discuss recent policy changes related to coverage of mental health and substance use disorder treatments.

About 5 Million Uninsured People Could Get ACA Marketplace Coverage Without a Monthly Premium – But They Would Have to Enroll Soon

Jan 10, 2023

News Release

About 5 million uninsured people across the country could get coverage through an Affordable Care Act Marketplace health plan with virtually no monthly premium if they enroll soon, a new KFF analysis finds. In most states, open enrollment runs through January 15, with tax credits available to help eligible low- and middle-income people afford coverage. Those tax credits would offset the full monthly premium for the lowest cost plan or plans for millions of uninsured…

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