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This analysis of insurance claims data finds that Congressional proposals to set a $35 per month cap on what people pay out of pocket for insulin would provide financial relief to at least 1 out of 5 insulin users with different types of private health insurance.
Our review of recent literature on premiums and cost-sharing is based on studies and reports published between 2017 and 2021. Our analysis of premiums in post-Affordable Care Act (ACA) Section 1115 waivers (approved under the Obama and Trump administrations) is based on available interim and final waiver evaluations as well as annual and quarterly state data reports posted on Medicaid.gov.
This analysis provides the latest data about Medicare Part D enrollment, premiums, and cost sharing in 2022 and trends over time, including information about stand-alone prescription drug plans (PDPs) and Medicare Advantage prescription drug plans.
For 2024, the average Medicare beneficiary has access to 43 Medicare Advantage plans and can choose from plans offered by 8 firms. Among the majority of Medicare Advantage plans that cover prescription drugs, 66 percent will charge no premium in addition to the monthly Medicare Part B premium. As in previous years, the vast majority of Medicare Advantage plans will offer supplemental benefits, including fitness, dental, vision, and hearing benefits.
This study compares the value of Medicare's fee-for-service benefits last year with the value of benefits in two large employer health plans -- a large health plan serving federal employees and a typical large employer Preferred Provider Organization (PPO) plan. For individuals ages 65 and older, the study finds that Medicare remains less generous on average than typical large employer health plans, even after recent improvements in the program's drug coverage. Overall, Medicare would cover…
With Vice President Harris promising to address medical debt as part of her economic plan, KFF Executive Vice President for Health Policy Larry Levitt explores why it is a symptom of the broader problem of affordable health care and reviews recent efforts to address it in this JAMA Health Forum post.
Family premiums for employer-sponsored health insurance rose 7% this year to reach an average of $25,572 annually, KFF’s 2024 benchmark Employer Health Survey finds. On average, workers contribute $6,296 annually to the cost of family coverage. This marks the second year in a row that premiums are up 7%. Over the past five years—a period of high inflation (23%) and wage growth (28%)—the cumulative increase in premiums has been similar (24%). While employers are…
This issue brief describes recent trends in the number of Medicaid outpatient prescriptions and the spending on those drugs and examines the implications of recent federal actions on future trends.
The survey provides an in-depth look at trends in employer-sponsored coverage in California, including premiums, cost sharing, offer rates, and employer strategies to manage costs and access to care, including comparisons to the nation overall.
This analysis examines access to, and consumers ability to find information on, a new twice annual long-acting PrEP drug during the first ACA open enrollment period since its approval. Despite the drug widely being considered a major advance, early evidence suggests that insurance coverage and benefit design decisions may create barriers to access.
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