Insurer Strategies to Control Costs Associated with Weight Loss Drugs
Affordable Care Act (ACA) Marketplace plans rarely cover GLP-1 drugs approved solely for obesity treatment, according to a an analysis of 2024 federal plan data.
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Affordable Care Act (ACA) Marketplace plans rarely cover GLP-1 drugs approved solely for obesity treatment, according to a an analysis of 2024 federal plan data.
More than two years ago President Biden signed into law Medicare drug pricing provisions in the Inflation Reduction Act. KFF's September Health Tracking Poll examines voter's views on these provisions and finds that large majorities of voters are unaware of the provisions despite reporting support for them.
Allowing Medicare to negotiate drug prices on behalf of older Americans remains broadly popular across partisans, though many voters are unaware of the new law and the billions of dollars it is expected to save in 2026, a new KFF Health Tracking Poll finds.
This brief examines the share of Medicare beneficiaries who reviewed their coverage and compared plans during the open enrollment period for 2022 (that takes place in the Fall of 2021), and who made use of Medicare’s official information resources, as well as variations by demographic groups. Overall, nearly 7 in 10 Medicare beneficiaries did not compare their own source of Medicare coverage with other Medicare options offered in their area.
This slideshow captures key data from the 2024 KFF Employer Health Benefits Survey survey, providing a detailed look at trends in employer-sponsored health coverage, including premiums, employee contributions, cost-sharing, abortion coverage, offer rates, wellness programs, and other employer practices.
This brief focuses on the stand-alone Medicare Part D prescription drug plan marketplace and its somewhat uncertain future, in light of recent trends in plan availability and the potential for another year of premium increases in 2026, in part depending on what the Trump administration decides to do with the temporary Part D premium stabilization demonstration. The brief explains why the stability of the PDP market matters, both for people in traditional Medicare who want prescription drug coverage but also for the viability of traditional Medicare as an option vis a vis Medicare Advantage.
In announcing these changes, CMS states that it is “facilitating the Part D program’s return to operating under regular market conditions.” Increasingly, however, these regular conditions appear unfavorable to the ongoing stability of the stand-alone prescription drug plan market, further tilting the playing field towards Medicare Advantage.
Some insurers in the ACA’s small group market are citing tariffs, particularly those affecting prescriptions drugs, as a reason for higher-than-expected premium increases.
This brief looks at premium changes for Medicare Part D stand-alone prescription drug plans between 2025 and 2026. For plans that were offered nationwide in 2025 and will continue to be offered in 2026, Part D enrollees in many states will see lower monthly premiums in 2026.
As Marketplace Open Enrollment nears, policy changes could leave millions of people facing substantially higher premiums and coverage loss, which could lead more consumers to purchase less expensive and less comprehensive coverage through short-term health plans. KFF analyzes short-term health policies sold by nine large insurers in 36 states, examining premiums, cost sharing, covered benefits, and coverage limitations and comparing them to ACA Marketplace plans.
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