Cost Sharing - Research and Data from KFF

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

Aug 21, 2018

Issue Brief

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.

Three firms Account for Over Half of All Medicare Part D Enrollees in 2018, and Pending Mergers Would Further Consolidate the Marketplace

May 17, 2018

News Release

In 2018, three Medicare Part D plan sponsors—UnitedHealth, Humana, and CVS Health—account for more than half of the program’s 43 million Part D enrollees (55%) and two-thirds of all stand-alone drug plan enrollees, indicating a marketplace that is dominated by a handful of major insurers, according to a new Kaiser Family Foundation analysis of Part…

Medicare Part D in 2018: The Latest on Enrollment, Premiums, and Cost Sharing

May 17, 2018

Issue Brief

This brief about the 2018 Medicare Part D marketplace analyzes the latest data on Medicare drug coverage and trends over time, including both stand-alone prescription drug plans and Medicare Advantage drug plans. The analysis focuses on enrollment, premiums, cost sharing, and the low-income subsidy.

Brief Examines Efforts to Create Health Plan Options that Don’t Comply with the Affordable Care Act’s Rules

Apr 18, 2018

News Release

Though Congress last year failed to repeal key Affordable Care Act requirements for non-group health insurance that people buy themselves, the Trump Administration and some states are promoting other types of plans through regulatory changes that would allow the sale of products that skirt many of the ACA’s requirements.

Abortion Coverage in the Bipartisan Health Care Stabilization Act of 2018 (S. 1771)

Mar 22, 2018

Issue Brief

This issue brief reviews current federal and state policies on private insurance coverage of abortion services, and how the Bipartisan Health Care Stabilization Act of 2018 would affect abortion coverage for women enrolled in the individual market.

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.

More Than One-Third of People with Traditional Medicare Spent at Least 20 Percent of Their Total Income on Health Care in 2013

Jan 29, 2018

News Release

Health care costs are a substantial and growing burden for many people on Medicare and are projected to consume a larger share of total income over time, according to a new analysis from the Kaiser Family Foundation.

The Biggest Health Issue We Aren’t Debating

Nov 22, 2017

From Drew Altman

In an Axios column, Drew Altman raises a health care issue that isn’t being debated, a large share of the public don’t have the assets to cover the cost sharing in their health plan if they get sick.

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.

Do Health Plan Enrollees have Enough Money to Pay Cost Sharing?

Nov 3, 2017

Issue Brief

This brief looks at the extent to which people have enough savings to meet the cost sharing requirements under private health insurance policies, which have risen substantially in recent years.

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