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  • New Alzheimer’s Drugs Spark Hope for Patients and Cost Concerns for Medicare

    Policy Watch

    The Food and Drug Administration granted full approval to Leqembi, a new Alzheimer's drug, on July 6, 2023. This updated policy watch focuses on the implications of Medicare coverage of the drug for program spending as well as equity and affordability issues for beneficiaries, and the potential for the Inflation Reduction Act to address the spending impacts. It also covers additional details from the Centers for Medicare and Medicaid Services about patient registries.

  • About 1 in 20 People with Private Insurance Received Services that Could be Affected by a District Court Ruling Limiting the ACA’s Preventive Services Mandate

    News Release

    A new KFF analysis finds about 1 in 20 privately insured people (5.7%) received at least one ACA preventive service or drug that could be affected by a now-stayed U.S. District Court ruling in Braidwood Management v. Becerra, which found the Affordable Care Act’s (ACA) preventive services mandate partially unconstitutional. The district court also found that pre-exposure prophylaxis (PrEP), medication recommended for HIV prevention, violates the religious rights of those who have objections to its…

  • Use of ACA preventive services potentially affected by Braidwood v. Becerra

    Issue Brief

    This analysis finds that about 10 million privately insured people received at least one ACA preventive service or drug that could be affected by a now-stayed U.S. District Court ruling, which found the Affordable Care Act's (ACA) requirement to cover certain preventive services without any cost sharing to be partially unconstitutional.

  • What is the Potential Impact of New Drugs for Obesity and Alzheimer’s Disease on Medicare Costs, Coverage and Beneficiaries? 

    News Release

    Two new KFF analyses examine the potential impact of Medicare coverage of new prescription drugs for obesity and Alzheimer’s disease on program spending and beneficiary out-of-pocket costs, as well as the role that the Inflation Reduction Act could play in mitigating these effects. Manufacturers of both types of drugs are lobbying for broad Medicare coverage of them, though they face different challenges. The availability of effective weight-loss drugs, including Novo Nordisk’s Ozempic and Wegovy (semaglutide)…

  • After the COVID-19 Public Health Emergency Ends on May 11, Some Consumers Could Face High Prices for COVID-19 Testing

    News Release

    After the public health emergency ends on May 11, private health plans will no longer be required to cover the full cost of COVID-19 tests ordered or administered by a clinician or to reimburse consumers for at-home rapid tests. To estimate what consumers might have to pay for tests, KFF’s new analysis draws on claims data showing what private insurers have paid for different types of COVID-19 tests, as well as hospitals’ published “self-pay” prices…

  • Prices for COVID-19 Testing

    Issue Brief

    This analysis examines the potential costs for COVID-19 testing that some consumers may face once the COVID-19 public health emergency ends on May 11, 2023., depending on whether they have insurance and how their insurance covers testing.

  • Standardized Plans in the Health Care Marketplace: Changing Requirements

    Issue Brief

    This brief examines the evolving requirements for insurers on HealthCare.gov to offer standardized plans that follow set cost sharing rules for covered benefits in addition to other plans they might offer. It also reviews how some state-run marketplaces have used standardized plans to limit cost sharing for insulin, mental health care, and other services.

  • Changes to Medicare Part D in 2024 and 2025 Under the Inflation Reduction Act and How Enrollees Will Benefit

    Issue Brief

    The Inflation Reduction Act of 2022 includes several provisions to lower prescription drug costs for people with Medicare and reduce drug spending by the federal government, including a number of changes to the Medicare Part D drug benefit. This brief provides an overview of the Part D benefit design and Part D enrollee cost-sharing requirements in 2023 and changes coming in 2024 and 2025.

  • How Have Costs Associated With Obesity Changed Over Time?

    Issue Brief

    This analysis finds that, among people with large employer health plans, those with an obesity diagnosis on average have higher total and out-of-pocket spending than those without an obesity diagnosis. It also examines the cost of common surgical and pharmacological treatments for obesity.