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To provide context for emerging debates about federal actions to address prescription drug costs, this issue brief highlights five key facts about Medicaid prescription drug coverage, payment, and administration.
This issue brief describes recent trends in the number of Medicaid outpatient prescriptions and the spending on those drugs and examines the implications of recent federal actions on future trends.
The Medicare drug price negotiation program could improve coverage of drugs selected for negotiation for Medicare beneficiaries because the law requires all Medicare Part D plans to cover each of the selected drugs, including all dosages and forms, when negotiated prices take effect.
This analysis examines 2026 Medicare Part D formulary coverage of drugs selected for negotiation to measure the effect of the IRA's coverage requirement.
Ahead of the Trump administration’s planned expansion of Medicare coverage for GLP-1s to treat obesity through temporary models and the availability of Medicare’s negotiated price for certain GLP-1 products beginning in 2027, this analysis examines CMS’s Medicare Part D claims data from 2019 to 2024 to document the increase in the number of beneficiaries being treated with GLP-1 drugs and the growth in Medicare spending and claims for these drugs.
This brief discusses the current landscape of Medicaid GLP-1 coverage and examines recent trends in Medicaid prescriptions and gross spending on GLP-1s.
As the ACA open enrollment deadline approaches amid the expiration of the enhanced premium tax credits, nearly six in 10 Marketplace enrollees say they would not be able to afford $300 more in annual health care costs, which may lead some to alternative coverage products, such as short-term plans, a type of private coverage that tends to have lower premiums but few consumer protections and limited benefits.
About one in eight adults say that they are currently taking a GLP-1 drug either to lose weight or treat a chronic condition, an increase from 18 months ago, though the high costs of the medications remain a concern. Few adults think it is likely their prescription costs will go down as a result of recently announced Trump administration policies.
While more large employers are covering GLP-1 drugs for weight loss, KFF's conversations with employers highlight concerns about the cost of these medications. Many of these employers have considered scaling back coverage of GLP-1 agonists for weight loss, or in some cases, employers are adding or strengthening coverage requirements.
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