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  • Medicare Part D Beneficiaries Who Reach the Catastrophic Coverage Limit Can Expect to Pay More Out-of-Pocket for Their Prescription Drugs Next Year

    News Release

    Medicare Part D enrollees with relatively high out-of-pocket expenses can expect see their costs rise in 2020, according to a new KFF analysis. This is mainly due to an increase in how much enrollees will pay out of pocket for their prescription drugs in the Part D benefit coverage gap phase before they qualify for catastrophic coverage. The analysis finds that out-of-pocket drug costs will increase by nearly $400 -- from $2,275 in 2019 to…

  • ACA Deductible FI

    The Average Marketplace Deductible Grew by About $1,000 Per Person in 2026, With More Enrollees Shifting to Higher-Deductible Plans as Enhanced Tax Credits Expired

    News Release

    The average Affordable Care Act (ACA) Marketplace deductible experienced the steepest increase in history—growing by 37% or over $1,000, from $2,759 in 2025 to $3,786 in 2026 as enhanced premium tax credits expired, according to a new KFF analysis. After the enhanced tax credits ended, many Marketplace shoppers shifted toward lower-premium, higher-deductible plans.

  • The AI Arms Race in Administrative Health Care

    Podcast

    Caroline Pearson, executive director of the Peterson Health Technology Institute (PHTI) and the Peterson Center on Healthcare, joins Chip to discuss who really benefits as AI moves into health care's back office. A quiet arms race is underway — providers deploying AI to code, bill, and capture revenue and insurers deploying it right back to review, deny, and hold the line. The open question is whether any of this lowers what the country actually spends…

  • ACA Deductible FI

    What We Know So Far About 2026 ACA Marketplace Enrollment, Premiums, and Deductibles

    Issue Brief

    This analysis examines early indicators of how the expiration of enhanced premium tax credits has affected effectuated enrollment levels (i.e., enrollment among people who have paid their premiums), plan selections, and out-of-pocket costs in 2026, drawing on plan selection and effectuated enrollment data from the Centers for Medicare & Medicaid Services (CMS) and state-based Marketplace (SBM) Open Enrollment reports, as well as KFF survey data and individual market enrollment estimates from Wakely Consulting Group.

  • 2025 Employer Health Benefits Survey

    Report

    This annual survey of employers provides a detailed look at trends in employer-sponsored health coverage, including premiums, worker contributions, cost-sharing provisions, offer rates, and more. This year's report also looks at how employers are approaching coverage of GLP-1 drugs for weight loss, including their concerns about utilization and cost.

  • Survey of People Who Purchase Their Own Insurance

    Poll Finding

    While most people in the U.S. get health insurance through their employer, about 14 million people under age 65 have coverage through the non-group or individual market, which has faced scrutiny recently in news reports about some insurers’ steep rate increases and in the market reforms in the new health reform law that will take effect in 2014. This survey provides insight into the current state of the non-group market and finds policyholders report that…

  • What the Actuarial Values in the Affordable Care Act Mean

    Issue Brief

    The Patient Protection and Affordable Care Act (PPACA) establishes four levels of coverage based on the concept of "actuarial value," which represents the share of health care expenses the plan covers for a typical group of enrollees. As plans increase in actuarial value – bronze, silver, gold, and platinum – they would cover a greater share of enrollees' medical expenses overall, though the details could vary across plans. The levels of coverage provided for in…

  • Restructuring Medicare’s Benefit Design: Implications for Beneficiaries and Spending

    Report

    Several deficit-reduction plans have proposed combining Medicare's separate deductibles for hospital and physician services, standardizing cost sharing across types of benefits, and establishing a new limit on annual out-of-pocket costs for beneficiaries. A new Kaiser Family Foundation study examines the potential implications of proposals to revamp Medicare’s cost-sharing requirements as a way of reducing federal spending. The analysis projects what would happen if Medicare's current benefit design were replaced with a unified deductible of $550;…

  • Aprenda sobre seguros médicos: los videos en español

    Video

    The YouToons help consumers understand health insurance by explaining health insurance premiums, out-of-pocket costs, and provider networks. These three videos are excerpts from the 2014 YouToons video, Health Insurance Explained – The YouToons Have It Covered.

  • Survey of Non-Group Health Insurance Enrollees, Wave 3

    Poll Finding

    The survey, conducted shortly after the close of the Affordable Care Act’s third open enrollment period, is the third in a series exploring the experiences of individuals who purchase their own health insurance in the nongroup market, including coverage purchased both inside and outside the ACA’s marketplaces. It examines enrollees’ satisfaction with their health plans’ premiums, deductibles, and provider networks, their views on affordability, shopping experiences, and problems encountered with their plans.