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  • Medigap and the Medicare “Doc Fix”

    News Release

    The House-passed legislation to repeal the Medicare Sustainable Growth Rate (SGR) includes a provision that would prohibit Medicare supplemental insurance (Medigap) policies from covering the Part B deductible for people who become eligible for Medicare beginning in 2020. A new Kaiser Family Foundation Data Note explores the implications of this proposal and finds that about 10 percent of 65-year olds on Medicare would have been affected in 2010 (the most recent year for which data…

  • State Medicaid Eligibility Policies for Individuals Moving Into and Out of Incarceration

    Issue Brief

    This brief highlights how state eligibility policies for incarcerated individuals differ, based on a review of state statutes, regulations, Medicaid eligibility manuals and other Medicaid agency guidance publicly available online and Medicaid managed care contracts. Overall, state Medicaid eligibility policies for justice-involved individuals moving into and out of incarceration vary, and these policies affect if and when individuals may enroll in Medicaid and the scope of any resulting savings.

  • 50-State Survey Finds Medicaid Enrollment Growth Slowing, with an Uptick in Spending Growth Driven by Provider Rate Increases and Rising Costs for Rx Drugs and Long-Term Care  

    News Release

    Medicaid enrollment growth slowed to 2.7 percent in state fiscal year 2017, down from 3.9 percent the prior year and far off the peak of 13.2 percent in 2015 that followed implementation of the Affordable Care Act’s (ACA) Medicaid expansion, according to a new survey from the Kaiser Family Foundation. Findings of Kaiser’s 17th annual 50-state survey of Medicaid directors across the country suggest the slowdown in enrollment growth may be attributable to the tapering…

  • Medicare Advantage 2017 Spotlight: Enrollment Market Update

    Issue Brief

    This Data Spotlight reviews national and state-level enrollment trends as of March 2017 and examines variation in enrollment by plan type and firm. It analyzes the most recent data on premiums, out-of-pocket limits, Part D cost-sharing for drugs, and plans’ quality ratings for Medicare Advantage enrollees.

  • State Data: What Has Happened to Health Coverage and Financing Under the Affordable Care Act?

    News Release

    As Congress presses forward with efforts to repeal and replace the Affordable Care Act, a new interactive map from the Kaiser Family Foundation provides a window into the changes in health insurance coverage and financing in each state under the 7-year-old law. The ACA increased enrollment in health insurance by expanding Medicaid, offering tax credits to low- and middle-income marketplace enrollees and reforming insurance market rules concerning coverage for people with pre-existing health conditions. Map…

  • 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…

  • 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…