Federal Budget

This infographic provides a snapshot of Medicare and end-of-life care in California.

In this Policy Insight, Jen Kates and Josh Michaud look at the prospects for the future of U.S. global health policy, examining whether long-term bipartisan support may be tested during a time of political transition, and identifying key areas of consensus among policymakers and the public.

While U.S. global health programs have enjoyed bipartisan support in the past, a new survey of the public and findings from interviews with global health and foreign policy experts suggest a growing partisan divide, as the country gears up for the 2016 election. Half (53%) of Americans say the U.S.…

After Congress provided an unprecedented level of emergency funding for Ebola in FY15 in response to the West African outbreak, beyond regular appropriations for global health programs, FY16 returned to business as usual. There was no additional emergency funding and global health amounts remained essentially flat funding compared to prior years. The FY16 Omnibus Appropriations bill, which was signed into law by the President on December 18, 2015, included an estimated $10.2 billion in funding for global health programs continuing a trend of essentially flat funding since FY10.

The Kaiser Family Foundation has tracked public opinion on global health issues in-depth since 2009. This most recent survey examines views on U.S. spending on health in developing countries and perceptions of barriers and challenges to making progress on the issue. Two-thirds of Americans (65 percent) overall and majorities of Democrats, independents and Republicans alike, say that the United States should play at least a major role in world affairs, including roughly one in five overall (18 percent) who say the U.S. should take the leading role. The survey also finds a general skepticism on the part of the American people when it comes to the effectiveness of global health spending, with seven in ten saying the “bang for the buck” of U.S. spending in this area is only fair or poor, and more than half believing that spending more on global health efforts won’t lead to meaningful progress (a share that has grown since 2012). Although many Americans have concerns about the value of global health spending, six in ten say the U.S. spends too little (26 percent) or about the right amount (34 percent) on global health, and three in ten say it spends too much. Most also recognize benefits to such spending, both for Americans at home as well as for people and communities in developing countries.

While global health has enjoyed significant bipartisan support among US policymakers over the past 15 years, the potential for changes in the political landscape in 2016 makes this an opportune time to assess the USG’s position relative to global health needs and funding. With this in mind, the Kaiser Family Foundation’s Global Health Policy Program asked Hart Research Associates and Public Opinion Strategies to solicit the views of specialists in foreign policy and global health.

Revamping traditional Medicare’s benefit design and restricting “first-dollar” supplemental coverage could reduce federal spending, simplify cost sharing, protect against high medical costs, decrease out-of-pocket spending for many beneficiaries, and provide more help to those with low incomes — but would be unlikely to achieve all of these goals simultaneously.

This report examines an approach to reforming Medicare that has been a focus of Congressional hearings and featured in several broader debt reduction and entitlement reform proposals, and was included in the June 2016 House Republican health plan. The analysis models four different options for modifying Medicare’s benefit design, all of which include a single deductible, modified cost-sharing requirements, a new cost-sharing limit, and a prohibition on first-dollar Medigap coverage. The analysis models the expected effects on out-of-pocket spending by beneficiaries in traditional Medicare, and assesses how each option is expected to affect spending by the federal government, state Medicaid programs, employers, and other payers, assuming full implementation in 2018.

This data note provides a snapshot of Medicare beneficiaries who died in 2014 and their Medicare spending at the end of life. It examines Medicare per capita spending trends over time since 2000 and in 2014, both overall and by type of service, for beneficiaries in traditional Medicare who died in a given year compared to those who survived the year.

As the U.S. enters a Presidential election year and the larger global health and development landscape changes, U.S. global health programs face a key moment of transition. The prior decade saw unprecedented attention to and funding for global health by the U.S. government. Although funding has flattened in recent years,…