View the Latest: Cost Sharing
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Annual Updates on Eligibility Rules, Enrollment and Renewal Procedures, and Cost-Sharing Practices in Medicaid and CHIP
ReportSince 2000, KFF's Program on Medicaid and the Uninsured has issued regular updates examining changes and trends in the eligibility rules, enrollment and renewal procedures and cost-sharing practices in Medicaid and CHIP. Those reports are compiled here.
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Navigating the Maze: A Look at Patient Cost-Sharing Complexities and Consumer Protections
Issue BriefThis brief focuses on consumers’ understanding of health insurance costs and examines existing federal protections that seek to address barriers to understanding the cost of coverage and care, such as price transparency, self-service price estimator tools, and simplifying cost-sharing designs.
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New Rule Proposes Changes to ACA Coverage of Gender-Affirming Care, Potentially Increasing Costs for Consumers
Issue BriefThis brief examines a proposed rule that seeks to change how ACA plans would cover gender affirming care services. If finalized the rule could lead insurers to drop coverage or shift costs to individuals and states, making access to gender affirming care more difficult.
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A Backlash Against Health Insurers, Redux
PerspectiveIn this JAMA Health Forum post, Executive Vice President Larry Levitt recalls the mid-1990s’ public backlash against Health Maintenance Organizations (commonly known as HMOs) – all of which preceded the recent outpouring of health insurance concerns – as well as how consumer protections against coverage restrictions have evolved and fallen short.
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As Governors Meet in D.C., Possible Federal Medicaid Cuts Loom as Big State Funding Issue
Quick TakeIn the face of reduced federal funding for Medicaid, states could be left with difficult choices – raise revenue or cut spending. Cuts to Medicaid could mean eliminating coverage for children, parents, working adults or those who might need long term care; limiting benefits; or cutting rates for plans or providers.
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FAQs about the Inflation Reduction Act’s Medicare Drug Price Negotiation Program
Issue BriefThe Centers for Medicare & Medicaid Services (CMS) recently announced the drugs selected for the second round of negotiation for the Medicare Drug Price Negotiation Program, which was established by the Inflation Reduction Act. These FAQs address several questions related to Medicare’s drug price negotiation program and CMS's implementation of the program, with a focus on the details that apply for 2027, the second year that negotiated prices will be available under the program.
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ACA Preventive Services at the Supreme Court
Quick TakeIf the Court rules in favor of Braidwood, private health insurers would no longer be required to cover, without cost sharing, certain preventive services recommended by USPTF after 2010 when the ACA was enacted.
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Medicare Part D in 2025: A First Look at Prescription Drug Plan Availability, Premiums, and Cost Sharing
Issue BriefMedicare Part D is a voluntary outpatient prescription drug benefit for people with Medicare provided through private plans, including stand-alone prescription drug plans and Medicare Advantage plans that offer drug coverage. This analysis provides an overview of Medicare Part D plan availability, premiums, and cost sharing in 2025 and key trends over time.
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Medicare Advantage Has Become More Popular Among the Shrinking Share of Employers That Offer Retiree Health Benefits
Issue BriefThis analysis examines the extent to which large private and non-federal public employers that offer retiree health benefits are turning to Medicare Advantage and why they are making this shift, using data from the 2024 Employer Health Benefits Survey. We find that slightly more than half (56%) of large employers offering retiree health benefits to Medicare-age retirees offer coverage to at least some retirees through a contract with a Medicare Advantage plan, more than double the share in 2017 (26%).