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  • Medigap Reforms: Potential Effects of Benefit Restrictions on Medicare Spending and Beneficiary Costs

    Report

    As part of several debt-reduction and Medicare-reform proposals, some policymakers propose to prohibit Medicare supplemental insurance policies (known as Medigap) from covering all of enrollees' out-of-pocket Medicare costs, which some believe leads to higher use of services and higher Medicare spending. Such changes would expose Medigap enrollees – currently about one in six Medicare beneficiaries – to a larger share of Medicare's cost-sharing requirements. This analysis commissioned by the Kaiser Family Foundation examines three potential…

  • How Much Skin in the Game is Enough? The Financial Burden of Health Spending for People on Medicare

    Report

    How Much " Skin in the Game " is Enough? The Financial Burden of Health Spending for People on Medicare Medicare extends health security and financial protection to seniors and younger people with disabilities. However, premiums, relatively high cost-sharing requirements, and gaps in the benefit package result in some beneficiaries spending a significant share of their income on health expenses. This data spotlight examines the burden out-of-pocket expenses placed on Medicare beneficiaries between 1997 and…

  • Accountable Care Organizations: A New Paradigm for Health Care Delivery?

    Event Date:
    Event

    The health reform law of 2010 authorizes Medicare, beginning next year, to contract with accountable care organizations (ACOs) in a Medicare Shared Savings Program. ACOs provide financial incentives to improve the coordination and quality of care for Medicare beneficiaries, while reducing costs. But providers have raised red flags, saying the arrangements are burdensome and too hard to achieve. This briefing addresses questions raised by the law and the subsequent regulation implementing ACOs, including: How will…

  • Federal Core Requirements And State Options In Medicaid: Current Policies And Key Issues

    Fact Sheet

    Medicaid is a jointly financed partnership between the federal government and states. The federal-state financing and administrative structure of Medicaid provides a framework of federal core requirements along with broad state options for program design and administration. This issue brief presents an overview of the current Medicaid program framework, with a focus on eligibility, benefits and cost sharing, care delivery and provider payment, long-term services and supports, and dual eligibles, as well as key issues…

  • 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…

  • Health Reform Hits Main Street

    Video

    This short cartoon explains the problems with the current health care system, the health reform changes that are happening now, and the big changes coming in 2014 as part of the Affordable Care Act (ACA). You can view the video on our site and it is also available on YouTube.

  • Family Health Premiums Rise 3 Percent to $13,770 in 2010, But Workers’ Share Jumps 14 Percent as Firms Shift Cost Burden

    News Release

    About One In Four Covered Workers Now Face Annual Deductibles Of $1,000 Or More, Including Nearly Half Of Those Employed By Small Businesses WASHINGTON, D.C. --  Workers on average are paying nearly $4,000 this year toward the cost of family health coverage - an increase of 14 percent, or $482, above what they paid last year, according to the benchmark 2010 Employer Health Benefits Survey released today by the Kaiser Family Foundation and the Health…

  • 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’s in There? The New Health Reform Law and Medicare

    Event Date:
    Event

    As part of an ongoing series to explore what is in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, this May 7 briefing sponsored by the Alliance for Health Reform and the Kaiser Family Foundation examines how the reform law affects Medicare. Changes to Medicare were among the most hotly debated issues as the legislation was developed, and this briefing includes a detailed look at the…