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As policymakers debate how to address the high cost of prescription drugs, a new KFF analysis compares data on prescription drug spending and use across large employer plans, Medicare Part D and Medicaid, and provides context for policy discussions about different approaches to curb rising drug costs that would affect people covered by each of…
Prescription drug costs are a pressing concern for both consumers and policymakers. This analysis compares prescription drug spending and use in large private employer plans, Medicare Part D, and Medicaid, based primarily on claims data by payer, which does not account for rebates.
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 brief highlights low-income workers and the impact of ACA coverage expansions on this population. Low-income workers may not have access to jobs that provide full-time, full-year employment or jobs with comprehensive benefit packages, including health insurance. Medicaid plays an important role in providing health coverage for low-income workers, and coverage expansions implemented under the ACA have produced substantial coverage gains for low-income workers and a corresponding reduction in the uninsured. However, low-income workers in non-expansion states with incomes too high for Medicaid but too low for subsidies in the Marketplace do not have an affordable coverage option and will likely remain uninsured.
This brief highlights voices from adult focus group participants with low and moderate incomes who gained Medicaid or Marketplace coverage following implementation of the ACA. It focuses on work, including work status, the new labor market, job benefits, and the role of ACA coverage for those with non-traditional jobs.
Affording health care ranks at the top of Texans’ financial concerns, with more than half (55%) saying it is difficult for them and their families to afford health care, including a quarter (25%) who say it is “very difficult,” finds a new Kaiser Family Foundation/Episcopal Health Foundation poll of Texas residents.
Using data from the Kaiser Family Foundation/Episcopal Health Foundation 2018 Texas Health Policy Survey, this brief explores Texas residents’ experiences with health care affordability and access to care. It examines Texans’ difficulty affording health care compared to other basic needs, problems paying medical bills, and skipping or postponing care because of costs. It also explores the experiences of vulnerable groups like the uninsured and those with lower incomes.
With rising concern over increases in prescription drug costs, the Trump Administration has proposed what it calls a “5-part plan” that would change several features of the Medicare Part D drug benefit. This brief describes the Administration’s five Part D proposals and discusses the potential implications for people with Part D prescription drug coverage and Medicare program spending, based on estimates from the Congressional Budget Office.
Immigrants living along the Texas Gulf Coast were more likely than their U.S.-born neighbors to suffer employment and income losses as a result of Hurricane Harvey (64% vs. 39%), a new Kaiser Family Foundation/Episcopal Health Foundation analysis finds.
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