Amid heightened public concern, the cost of prescription drugs is a focus of attention by the Biden administration and lawmakers in Congress and state capitals. Proposed actions range from allowing Medicare to negotiate the prices of certain drugs to limiting some drug price increases to inflation and capping out of pocket costs for Medicare beneficiaries in Part D, among other initiatives. See KFF’s research, analysis and public opinion data, as well as Kaiser Health News’ journalism, related to prescription drugs and their costs.

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Medicaid’s Prescription Drug Benefit: Key Facts

Medicaid provides health coverage for millions of Americans, including prescription drug coverage for many people with substantial health needs. This fact sheet provides an overview of Medicaid’s prescription drug benefit and recent trends in spending and utilization

2019 Employer Health Benefits Survey

Annual premiums for employer-sponsored family health coverage reached $20,576 this year, up 5% from last year, with workers on average paying $6,015 toward the cost of their coverage. The average deductible among covered workers in a plan with a general annual deductible is $1,655 for single coverage. Fifty-six percent of small firms and 99% of large firms offer health benefits to at least some of their workers, with an overall offer rate of 57%.

States Focus on Quality and Outcomes Amid Waiver Changes: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2018 and 2019

This report provides an in-depth examination of the changes taking place in Medicaid programs across the country. Report findings are drawn from the annual budget survey of Medicaid officials in all 50 states and the District of Columbia. This report examines the reforms, policy changes, and initiatives that occurred in FY 2018 and those adopted for implementation for FY 2019 (which began for most states on July 1, 2018). Key areas covered include changes in eligibility, managed care and delivery system reforms, long-term services and supports, provider payment rates and taxes, covered benefits, and pharmacy and opioid strategies.

Utilization and Spending Trends in Medicaid Outpatient Prescription Drugs, 2015-2019

Prescription drug spending in Medicaid and other health programs has returned to the national policy debate. This analysis examines Medicaid outpatient prescription drug utilization and spending before rebates over the 2015 to 2019 period, which is helpful for understanding recent cost drivers and areas for targeted policy action.

What’s the Latest on Medicare Drug Price Negotiations?

In response to prescription drug spending growth and heightened attention to drug prices, some policymakers have proposed allowing the federal government to negotiate the price of prescription drugs for Medicare and private payers. This brief describes the current status of drug price negotiation proposals, looks back at the history of proposals to give the federal government the authority to negotiate drug prices in Medicare, describes the negotiation provisions in key legislation (H.R. 3), and discusses the potential spending effects for the federal government, beneficiaries, and private payers.

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