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Data Note: Data Do Not Support Relationship Between Medicaid Expansion Status and Home and Community-Based Services Waiver Waiting Lists

Some have said that state choices about whether to adopt the ACA’s Medicaid expansion come at the expense of providing Medicaid home and community-based services (HCBS). Since 2002, the Kaiser Family Foundation has surveyed states about their HCBS waiver waiting lists. All states offer at least one HCBS waiver for seniors and people with disabilities today. States choose how many people to serve under these waivers, and their ability to limit enrollment can result in waiting lists when the number of people seeking services exceeds the number of waiver slots. This analysis examines the most recent data available, including HCBS waiver waiting list data for 2015 and 2016. The data do not support a relationship between a state’s Medicaid expansion status, which is primarily financed with federal funds, and changes in its HCBS waiver waiting list.

How Many Seniors Are Living in Poverty? National and State Estimates Under the Official and Supplemental Poverty Measures in 2016

This analysis presents national and state estimates of poverty under two different measures of poverty for adults ages 65 and older. Current estimates of poverty based on the Supplemental Poverty Measure–which takes into account financial resources and liabilities, out-of-pocket medical spending, and geographic variation in housing costs–indicate that the share (and number) of older adults who are struggling financially is larger than is conveyed by the official poverty measure.

The Financial Burden of Health Care Spending: Larger for Medicare Households than for Non-Medicare Households

Medicare offers health and financial protection to nearly 60 million adults ages 65 and over and younger people with disabilities. However, the high cost of premiums, cost-sharing requirements, and gaps in the Medicare benefit package can result in beneficiaries devoting a substantial share of their total household spending to health care costs.This analysis compares health-related expenses as a share of total household spending for Medicare and non-Medicare households, using the 2016 Consumer Expenditure Survey. We estimate how much Medicare and non-Medicare households spent on health care, including premiums, compared to other household spending (e.g., housing, transportation, and food).

Medicare Beneficiaries’ Out-of-Pocket Health Care Spending as a Share of Income Now and Projections for the Future

Medicare helps pay for the health care needs of 59 million people, including adults ages 65 and over and younger adults with permanent disabilities. Even so, many people on Medicare incur relatively high out-of-pocket costs for their health care. This report assesses the current and projected out-of-pocket health care spending burden among Medicare beneficiaries, analyzing spending as a share of Social Security income and total income, for beneficiaries overall, and by demographic, socioeconomic, and health status measures, for 2013 and projections for 2030.

Medicaid Home and Community-Based Services: Results From a 50-State Survey of Enrollment, Spending, and Program Policies

This report summarizes the national trends to emerge from the latest (2014) enrollment and spending data for the three main Medicaid home and community-based services (HCBS) programs: (1) the mandatory home health services state plan benefit, (2) the optional personal care services state plan benefit, and (3) optional § 1915 (c) HCBS waivers. It also highlights key findings on 2016 program policies, such as waiting lists, managed long-term services and supports, and provider payment rates.

An Overview of Medicare

This issue brief provides an overview of Medicare, the health insurance program for people ages 65 and over and younger people with permanent disabilities. The brief review the characteristics of people on Medicare, what Medicare covers, benefit gaps and supplemental coverage, beneficiaries’ out-of-pocket health care spending, program spending and financing, payment and delivery system reform, and issues for the future of Medicare.

No Limit: Medicare Part D Enrollees Exposed to High Out-of-Pocket Drug Costs Without a Hard Cap on Spending

The Medicare Part D prescription drug benefit has helped improve the affordability of medications for people with Medicare, but enrollees can face relatively high out-of-pocket drug costs because there is no hard cap on out-of-pocket spending under Part D. This analysis examines out-of-pocket prescription drug spending among Medicare Part D enrollees with costs above the catastrophic coverage threshold.

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.