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.

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.

Kaiser Health Tracking Poll – November 2017: The Politics of Health Insurance Coverage, ACA Open Enrollment

This month marks the start of the ACA’s fifth open enrollment period and finds three in ten of the public saying they haven’t heard anything at all about the current open enrollment period. Despite their overall views of the ACA, the majority of the public (61 percent) – including most Democrats (71 percent), independents (58 percent), and half of Republicans (52 percent) – say that because President Trump and Republicans in Congress are now in control of the government, they are responsible for any problems with the health care law moving forward. This month’s tracking poll also examines public support for two variations of a Medicare buy-in proposal.

Medigap Reform: Setting the Context for Understanding Recent Proposals

This brief presents the most current data available on the Medicare supplemental insurance (Medigap) market, including enrollment and premiums by state and plan type, analyzes how many beneficiaries have first dollar coverage (particularly Plans C and F), and describes recent Medigap proposals that have emerged as part of efforts to reduce Medicare spending and the national debt.

The Gap in Medigap

This policy insight examines the low rate of Medigap coverage among people under age 65 with disabilities on Medicare and the federal law that governs consumer rights and protections related to Medigap open enrollment.