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  • Renewals in Medicaid and CHIP: Implementation of Streamlined ACA Policies and the Potential Role of Managed Care Plans

    Issue Brief

    This brief reviews the new renewal requirements for Medicaid and CHIP that are designed to maintain continuity of coverage for eligible individuals. It provides an overview of state implementation of the new renewal policies and considers the potential role managed care plans can play in supporting renewals. Key findings include: some aspects of the simplified renewal policies have not yet been fully implemented due to a range of challenges; some states, including Washington and Rhode…

  • To Switch or Be Switched: Examining Changes in Drug Plan Enrollment among Medicare Part D Low-Income Subsidy Enrollees

    Report

    During the Medicare Part D annual enrollment period, people on Medicare can review and compare stand-alone prescription drug plans (PDPs) and Medicare Advantage plans and switch plans if they choose. Low-income beneficiaries who receive premium and cost-sharing assistance through the Part D Low-Income Subsidy (LIS) program have a subset of premium-free PDPs (benchmark plans) available to them, but can also choose to enroll in a non-benchmark plan and pay a premium. This analysis examines plan…

  • 2015 Survey of Health Insurance Marketplace Assister Programs and Brokers

    Report

    This nationwide survey analysis of Marketplace consumer assistance programs and brokers examines the nature of Marketplace assistance during the second open enrollment period for 2015 coverage, and offers unique insights into how Affordable Care Act (ACA) implementation is progressing, what is changing, and what challenges remain. Building upon our Survey of Health Insurance Marketplace Assister Programs (2014), the analysis compares Assister Program capacity and experiences from the first open enrollment period to the next, and…

  • Medicare Advantage 2019 Spotlight: First Look

    Issue Brief

    In 2019, more than 20 million Medicare beneficiaries (34%) are enrolled in Medicare Advantage plans, which are mainly HMOs and PPOs offered by private insurers as an alternative to the traditional Medicare program. This issue brief provides an overview of the Medicare Advantage plans that will be available in 2019, including the variation in the number of plans available by county and plan type. The brief also examines the insurers entering the Medicare Advantage market…

  • Do People Who Sign Up for Medicare Advantage Plans Have Lower Medicare Spending?

    Issue Brief

    The analysis finds that people who switched from traditional Medicare to Medicare Advantage in 2016 had health spending in 2015 that was $1,253 less, on average, than the average spending for beneficiaries who remained in traditional Medicare (after adjusting for health risk). The findings suggest that the current payment method may systematically overestimate expected costs of Medicare Advantage enrollees. Adjusting payments to reflect Medicare Advantage enrollees’ prior use of health services could potentially lower total…

  • What Percent of New Medicare Beneficiaries Are Enrolling in Medicare Advantage?

    Issue Brief

    The analysis examines enrollment in Medicare Advantage plans during beneficiaries’ first year on Medicare and finds that less than one-third or 29% enrolled in these private health plans, including HMOs or PPOs. The majority of people new to Medicare are choosing traditional Medicare in the year they first go on Medicare. The study looks at how these findings vary across age, Medicaid status, states, and counties.

  • Less Than One-Third of New Medicare Beneficiaries Enrolled in Medicare Advantage During Their First Year on Medicare 

    News Release

    Twenty-nine percent of new beneficiaries chose to enroll in Medicare Advantage during their first year in Medicare in 2016, finds a new KFF analysis. That level generally matches the overall share of beneficiaries who opted for Medicare Advantage that year, but does not support the view that the aging Baby Boom generation, having had more experience with HMOs and PPOs during their working years, would select the private plans over traditional Medicare at relatively high…

  • Medicaid Enrollment & Spending Growth: FY 2018 & 2019

    Issue Brief

    This issue brief provides an overview of Medicaid spending and enrollment growth with a focus on state fiscal years 2018 and 2019. Findings are based on interviews and data provided by state Medicaid directors as part of the 18th annual survey of Medicaid directors in all 50 states and the District of Columbia conducted by the Kaiser Family Foundation (KFF) survey and Health Management Associates (HMA). Findings examine changes in overall enrollment and spending growth.