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The Silent Affordability Crisis Facing Sick People

In this Axios column, Drew Altman shows that employer coverage for lower wage workers is much worse than ACA marketplace coverage for similar populations. It’s a bigger problem we need to talk about more, he says.

Do People Who Sign Up for Medicare Advantage Plans Have Lower Medicare Spending?

The analysis finds that people who switched from traditional Medicare to Medicare Advantage in 2016 had health spending in 2015 that was $1,253 less, on average, than the average spending for beneficiaries who remained in traditional Medicare (after adjusting for health risk). The findings suggest that the current payment method may systematically overestimate expected costs of Medicare Advantage enrollees. Adjusting payments to reflect Medicare Advantage enrollees’ prior use of health services could potentially lower total Medicare spending by billions of dollars over a decade.

Household Health Spending Calculator

A new interactive tool highlights how much individuals and families in the U.S. spend on health. Users can generate scenarios based on family size, income level, insurance source, and health status. The calculator estimates direct costs, like premiums, out-of-pocket costs, and state and federal taxes that fund health programs, as well as less…

10 Essential Facts About Medicare and Prescription Drug Spending

Prescription drugs play an important role in medical care for 60 million seniors and people with disabilities, and account for nearly $1 out of every $5 in Medicare spending. This chart series examines trends in Medicare and beneficiary out-of-pocket spending on prescription drugs, and what the public thinks about different options for keeping drug costs down.

Testimony: Pre-Existing Conditions and Health Insurance

KFF’s Karen Pollitz testimony before the U.S. House Committee on Ways and Means on Jan. 29, 2019 examines the prevalence of pre-existing conditions, the impact of the Affordable Care Act’s prohibition against medical underwriting and other provisions aimed at stabilizing the insurance risk pool, and the trade-offs involved in relaxing those provisions. 

How Many of the Uninsured Can Purchase a Marketplace Plan for Free?

This analysis looks at how many of the remaining uninsured are eligible for premium subsidies that are large enough to cover the entire cost of a bronze plan, which is the minimum level of coverage available on the Marketplaces. It estimates 27% of uninsured individuals who could shop on the ACA Marketplace, or 4.2 million people nationwide, are eligible to purchase a bronze plan with $0 premiums after subsidies in 2019.