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  • Adding an Out-of-Pocket Spending Maximum to Medicare: Implementation Issues and Challenges

    Issue Brief

    In an effort to simplify Medicare’s cost-sharing requirements, provide beneficiaries with catastrophic protection, and achieve program savings, some have proposed to restructure Medicare’s benefit design. Several recent proposals would create a unified deductible for Medicare Parts A and B, simplify cost-sharing requirements above the deductible, and add an annual limit on beneficiary out-of-pocket spending—a benefit feature typical of larger employer plans, but lacking in traditional Medicare. This issue brief describes the options for adding an out-of-pocket spending limit to Medicare and examines the operational issues that could arise in implementing both a uniform and an income-based out-of-pocket spending limit. Because the implementation of an income-related out-of-pocket maximum would pose somewhat greater complexity for Medicare, the operational issues associated with this approach are discussed in greater detail.

  • Policy Options to Sustain Medicare for the Future

    Report

    With Medicare expected to be a key part of Washington’s ongoing debate about solutions to reduce the federal budget and national debt, this report serves as a compendium of policy options that may be discussed in upcoming budget debates. The report presents a wide array of options in several areas and lays out the possible implications of these options for Medicare beneficiaries, health care providers, and others, as well as estimates of potential savings, when available.

  • Health Care Costs Top the Public’s List of Financial Worries, and Those Who Are Struggling the Most Want to Hear Presidential Candidates Discuss Economic and Health Care Issues

    News Release

    At a time when kitchen table economic problems are on voters’ minds, unexpected medical bills and health care costs top the public’s list of financial concerns, and voters who are struggling to pay their monthly bills are the most eager to hear the presidential candidates talk about economic and health care issues, the latest KFF…

  • Compare Proposals to Replace The Affordable Care Act

    Interactive

    President Donald Trump and Republicans in Congress have committed to repealing and replacing the Affordable Care Act (ACA). How do their replacement proposals compare to the ACA? How do they compare to each other? Includes the Graham-Cassidy-Heller-Johnson amendment (introduced 9/13/2017) as well as other proposals from key members of Congress.

  • What’s in the Administration’s 5-Part Plan for Medicare Part D and What Would it Mean for Beneficiaries and Program Savings?

    Issue Brief

    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.