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  • Millions of People with Medicare Will Benefit from the New Out-of-Pocket Drug Spending Cap Over Time

    Issue Brief

    In 2025, Medicare beneficiaries will pay no more than $2,000 out of pocket for prescription drugs covered under Part D, Medicare’s outpatient drug benefit, due to a provision in the Inflation Reduction Act of 2022. This analysis examines how many Medicare Part D enrollees spent $2,000 or more out of pocket in 2021 and over multiple years, both nationally and at the state level, to show how many people over time could benefit from the new Part D spending cap.

  • The Effect of Delaying the Selection of Small Molecule Drugs for Medicare Drug Price Negotiation

    Policy Watch

    In a new Trump administration executive order, the Secretary of HHS is directed to work with Congress to implement a change in law to delay negotiation of so-called “small molecule” drugs under the Inflation Reduction Act's Medicare Drug Price Negotiation Program for an additional 4 years. This brief analyzes how many of the drugs previously selected for negotiation would not have been eligible if this policy had been in place at the time.

  • Medicare Advantage Payments to Increase Again

    Quick Take

    The increase translates into an additional $35 billion to Medicare Advantage plans in 2026 compared to this year….The increase in payments is larger than for 2025 (3.7%) or 2024 (3.3%), but below the increase for 2023 (8.5%), and comes at a time of increasing scrutiny over Medicare Advantage payments.

  • A New Use for Wegovy Opens the Door to Medicare Coverage for Millions of People with Obesity

    Issue Brief

    The FDA recently approved a new use for Wegovy, the blockbuster anti-obesity drug, to reduce the risk of heart attacks and stroke in people with cardiovascular disease who are overweight or obese - a decision that opens the door to Medicare coverage of Wegovy, which is prohibited by law from covering drugs used for obesity. This brief analyses how many Medicare beneficiaries could be eligible for the new use of Wegovy and the potential impact on Medicare spending.

  • Medicare Spending on Ozempic and Other GLP-1s Is Skyrocketing

    Policy Watch

    This policy watch analyzes the latest data on Medicare Part D spending on GLP-1 drugs, initially approved to treat diabetes but in high demand as treatments for obesity, and shows how spending on these drugs has increased substantially in recent years.

  • Options to Make Medicare More Affordable For Beneficiaries Amid the COVID-19 Pandemic and Beyond

    Report

    Medicare provides significant health and financial protections to more than 60 million Americans, but there are gaps in coverage and high cost-sharing requirements that can make health care difficult to afford. This report analyzes several policy options that could help make health care more affordable for people covered by Medicare, especially beneficiaries with relatively low incomes: adding an out-of-pocket limit to traditional Medicare, adding a hard out-of-pocket cap to Part D, expanding financial assistance through the Medicare Savings Programs, and expanding financial assistance through the Part D low-income subsidy program.