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Changes to the Medicare Part D benefit in the Inflation Reduction Act will mean lower out-of-pocket costs for Part D enrollees but higher costs for Part D plans overall, leading to concerns about possible premium increases. These FAQs provide context for understanding Part D premiums in 2025 and changes in recent years, and describe actions the Centers for Medicare & Medicaid Services (CMS) is taking to mitigate potential premium increases.
This brief analyzes 2024 Medicare Part D enrollment, premiums, and cost sharing. The analysis highlights the continued growth in Medicare Advantage enrollment in the Part D marketplace and substantially higher average monthly premiums for stand-alone Part D drug plan coverage. Changes to the Part D benefit included in the Inflation Reduction Act are helping to lower out-of-pocket costs for patients but could also contribute to higher-priced Part D coverage.
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.
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.
In response to higher drug spending growth and heightened attention to drug prices, policymakers have proposed a variety of policy initiatives to lower the cost of prescription drugs in Medicare. This brief examines in detail the range of proposals offered by the Trump Administration and members of Congress for lowering the cost of prescription drugs, their known effects on the federal budget, and their potential implications for beneficiaries and other stakeholders.
This brief describes how the Medicare Part D benefit will change in 2020 under current law and proposed changes that would affect what beneficiaries, plans, manufacturers, and Medicare pay for drug costs under Part D in the future.
Annual family premiums for employer-sponsored health insurance average $22,463 this year, similar to last year ($22,221), the 2022 benchmark KFF Employer Health Benefits Survey finds. On average, workers this year are contributing $6,106 toward the cost of family premium, with employers paying the rest.
With renewed discussion of the high cost of prescription drugs recently, the August Kaiser Health Tracking poll finds that most Americans feel that drug costs are unreasonable and that drug companies put profits before people. At the same time, the public largely values the role prescription drug companies play, with most saying that prescription drugs developed in the past two decades have made the lives of people in the U.S. better, including about 4 in 10 who say a lot better. When it comes to their views of the Affordable Care Act (ACA) this month, the American public remains divided in their opinion of the law. Those who favor repeal are divided on whether the law should be replaced with a Republican-sponsored alternative or if it should be repealed and not replaced
Given recent news about some high-cost prescription drugs and the debate about who should pay for them, this month’s Kaiser Health Tracking Poll has a special focus on the issue. Nearly three-quarters of the public think that the cost of prescription drugs is unreasonable. Americans place much of the blame with the drug companies saying they set prices too high and that company profits are a major factor in drug pricing. The poll also finds that most of the public still hasn’t heard much about the Supreme Court case on whether people in states with federal marketplaces are eligible for financial assistance to purchase health insurance. Most feel that Congress and states should act if the Court rules for the plaintiffs, but there is no agreement among partisans.
This month’s Kaiser Health Tracking Poll finds public opinion of the Affordable Care Act (ACA) continues to be almost evenly split The poll also asks about health care priorities for the President and Congress, and the concern that comes out on top for Democrats, Republicans and independents alike is making sure that high-cost drugs for chronic conditions are affordable to those who need them. Other than high-cost prescription drugs, Democrats, Republicans and independents have different ideas of their top priorities in health care. The poll also assesses Americans' use of comparative price and quality information about doctors, hospitals and health plans.
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