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Changes to the Medicare Part D benefit in the Inflation Reduction Act will mean lower out-of-pocket costs for Part D enrollees but higher costs for Part D plans overall, leading to concerns about possible premium increases. These FAQs provide context for understanding Part D premiums in 2025 and changes in recent years, and describe actions the Centers for Medicare & Medicaid Services (CMS) is taking to mitigate potential premium increases.
This analysis finds that the ACA’s maximum out-of-pocket limit is likely to grow faster than wages and salaries, and is also expected to grow faster than the maximum out-of-pocket limit for Health Savings Account (HSA)-qualified health plans.
A new issue brief looks at the prevalence of potential surprise medical bills based on patient diagnosis, emergency visits, and type of inpatient admission.
This primer on health care spending in the United States reviews the growth in health care spending since 1970 and the impact of health care costs on families and employers.
In an effort to simplify Medicare’s cost-sharing requirements, provide beneficiaries with catastrophic protection, and achieve program savings, some have proposed to restructure Medicare’s benefit design. Several recent proposals would create a unified deductible for Medicare Parts A and B, simplify cost-sharing requirements above the deductible, and add an annual limit on beneficiary out-of-pocket spending—a benefit feature typical of larger employer plans, but lacking in traditional Medicare. This issue brief describes the options for adding an…
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 health care has become somewhat less affordable even among those with health insurance. Since 2015, larger shares of people with health insurance say they have…
This 13th annual 50-state survey of Medicaid and CHIP eligibility, enrollment, renewal, and cost-sharing policies as of January 2015 provides a snapshot of state Medicaid and CHIP policies in place one year into the post-ACA era.
This annual Employer Health Benefits Survey (EHBS) provides a detailed look at trends in employer-sponsored health coverage, including premiums, employee contributions, cost-sharing provisions, and other relevant information. The 2015 EHBS survey finds average family health premiums rose 4 percent in 2015, relatively modest growth by historical standards.
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. This analysis uses data from the National Health and Nutrition Examination Survey (NHANES), the Medicare Current Beneficiary Survey Cost and Use file (MCBS), the National Health Interview Survey (NHIS) and the Kaiser Family Foundation Survey of Health Care Among Nonelderly People with…
This data note examines the effects of rising EpiPen prices on Medicare and beneficiaries. We analyze EpiPen spending, in the aggregate and per user, in Medicare Part D between 2007 (the year after the Part D drug benefit took effect, and the year Mylan acquired the product) and 2014 (the most recent year of data available).
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