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Changes to the Medicare Part D benefit in the Inflation Reduction Act will mean lower out-of-pocket costs for Part D enrollees but higher costs for Part D plans overall, leading to concerns about possible premium increases. These FAQs provide context for understanding Part D premiums in 2025 and changes in recent years, and describe actions the Centers for Medicare & Medicaid Services (CMS) is taking to mitigate potential premium increases.
More than two years ago President Biden signed into law Medicare drug pricing provisions in the Inflation Reduction Act. KFF's September Health Tracking Poll examines voter's views on these provisions and finds that large majorities of voters are unaware of the provisions despite reporting support for them.
With open enrollment less than a month away, a new KFF analysis suggests that the vast majority of the nation’s 67 million Medicare beneficiaries will not shop around among the coverage options for 2025 or switch plans. It’s a decision that could have a significant impact on enrollees’ coverage and costs.
This brief focuses on the stand-alone Medicare Part D prescription drug plan marketplace and its somewhat uncertain future, in light of recent trends in plan availability and the potential for another year of premium increases in 2026, in part depending on what the Trump administration decides to do with the temporary Part D premium stabilization demonstration. The brief explains why the stability of the PDP market matters, both for people in traditional Medicare who want prescription drug coverage but also for the viability of traditional Medicare as an option vis a vis Medicare Advantage.
In announcing these changes, CMS states that it is “facilitating the Part D program’s return to operating under regular market conditions.” Increasingly, however, these regular conditions appear unfavorable to the ongoing stability of the stand-alone prescription drug plan market, further tilting the playing field towards Medicare Advantage.
This brief considers how default enrollment into Medicare Advantage might work, potential challenges with this approach, and implications for beneficiaries, insurers, providers, agents and brokers, and the federal budget.
This issue brief describes the impact of H.R.1's 10-year delay in implementing provisions in two Medicaid eligibility rules that would have reduced red tape. The delayed rules are projected to decrease federal spending and future Medicaid and CHIP enrollment and increase coverage loss.
This brief looks at premium changes for Medicare Part D stand-alone prescription drug plans between 2025 and 2026. For plans that were offered nationwide in 2025 and will continue to be offered in 2026, Part D enrollees in many states will see lower monthly premiums in 2026.
The Build Back Better Act (BBBA) includes a range of health and other proposals supported by President Biden, including a proposal to allow the federal government to negotiate the price of some prescription drugs covered under Medicare Part B (administered by physicians) and Medicare Part D (retail outpatient drugs). This brief illustrates the potential scope of the drug price negotiation proposal in the BBBA. This analysis is designed to highlight the types of Medicare-covered drugs that could be subject to negotiation, and which of the current top-spending drugs covered by Part B and Part D could be subject to price negotiation, and in what years, if the BBBA is enacted.
The Medicare Part D program provides an outpatient prescription drug benefit to older adults and people with long-term disabilities in Medicare who enroll in private plans. This brief analyzes Medicare Part D enrollment and costs in 2023 and trends over time. The analysis highlights the substantial growth of Medicare Advantage drug plans in the marketplace for Part D drug coverage, where enrollment overall is concentrated in a handful of large plan sponsors.
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