President Donald Trump and the GOP congressional leaders have talked about modernizing Medicare, including a proposal from House Republicans to create a premium-support system for Medicare.  In the wake of passage of the GOP tax bill, which is expected to add to the national debt, there may be a focus on reining in the cost of entitlement programs such as Medicare, which may have significant implications for the Medicare program and its beneficiaries. The Trump administration also has shown interest in prescription drug spending in Medicare as well as in Medicare delivery system reform efforts such as Accountable Care Organizations, bundled payments and medical homes. Medicare Advantage now covers 1 in 3 Medicare beneficiaries and recent trends toward consolidation among insurers could have implications for beneficiaries.
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An Analysis of the Share of Medicare Beneficiaries Who Would Benefit from an Annual Out-of-Pocket Maximum under Traditional Medicare Over Multiple Years

This analysis examines the share of Medicare beneficiaries who would be helped over time if the program were to add a limit on out-of-pocket spending to traditional Medicare. This analysis was conducted jointly with the Medicare Payment Advisory Commission (MedPAC) in response to a request made during a Feb. 26, 2013 hearing of the House Ways and Means’ Subcommittee on Health.

Comparison of Medicare Premium Support Proposals

This brief provides a side-by-side comparison of recent proposals to transform Medicare into a premium support program and slow the future growth in Medicare spending. These proposals each would convert Medicare from a defined benefit program, in which beneficiaries are guaranteed coverage for a fixed set of benefits, to a…

Raising Medicare Premiums for Higher-Income Beneficiaries: Assessing the Implications

As policymakers consider ways to slow the growth in Medicare spending as part of broader efforts to reduce the federal debt or offset the cost of other spending priorities, some have proposed to increase beneficiary contributions through higher Medicare premiums. This issue brief explains provisions of current law that impose income-related premiums under Medicare Part B and Part D, describes recent proposals to modify these requirements, and analyzes the potential implications for the Medicare population.

The Budget Control Act of 2011: Implications for Medicare

Beginning January 2013, Medicare spending will be subject to automatic, across-the-board reductions, known as “sequestration,” which is slated to reduce Medicare payments to plans and providers by up to 2 percent. This sequestration results from provisions in the Budget Control Act of 2011, which raised the debt ceiling and will…

Making Ends Meet: The Medicare Generation

This short Kaiser Family Foundation documentary profiles the experiences of three Medicare families trying to pay for their health care costs with other household spending. The families are among 16 featured in a companion report examining the role Medicare now plays in the lives of beneficiaries and the challenges many…

Medicare’s Income-Related Premiums: A Data Note

This data note presents new information to help set a context for understanding the implications of recent changes to Medicare’s income-related premiums incorporated in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), a new law to repeal and replace Medicare’s Sustainable Growth Rate (SGR) formula for physician payments. It describes current requirements with respect to the income-related premiums under Medicare Part B and Part D, including the number and share of Medicare beneficiaries who are estimated to pay income-related premiums and revenues raised from the income-related premium, based on data from the Centers for Medicare and Medicaid Services (CMS) Office of the Actuary (OACT). It also explains the recently enacted changes in MACRA that will affect some higher-income people on Medicare who are already paying income-related premiums, beginning in 2018.

Private Contracts Between Doctors and Medicare Patients: Key Questions and Implications of Proposed Policy Changes

Changes in Medicare’s private contracting laws could have significant implications for beneficiaries, doctors, and the Medicare program. This brief summarizes the three options that physicians and practitioners currently have for charging Medicare patients, explains how private contracting works in Medicare under current law, and reviews current proposals on changes to private contracting in Medicare, as well as their implications for patients, physicians, and the Medicare program.