Some recent proposals to lower prescription drug costs would require drug manufacturers to pay a rebate to the federal government if their prices for drugs covered under Medicare Part B and Part D increase by more than the rate of inflation. As context for understanding these proposals, this data note analyzes changes in list prices for drugs covered by Medicare Part D in recent years compared to changes in the rate of inflation.
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In response to higher drug spending growth and heightened attention to drug prices, some policymakers have proposed allowing Medicare to negotiate the price of prescription drugs. This issue brief provides a short history of this proposal, describes several bills introduced in the 116th Congress to allow government negotiations as well as assessments of potential savings from the Congressional Budget Office (CBO), and considers the prospects for action in the future.
This issue brief examines the latest facts about Medicare spending and financing, including the most recent historical and projected Medicare spending data from the Centers for Medicare and Medicaid Services Office of the Actuary, the 2019 annual report of the Boards of Medicare Trustees, and the 2019 Medicare baseline and projections from the Congressional Budget Office. It discusses historical and projected spending trends, program financing, Medicare’s financial condition, and the future outlook.
This data note explores the attitudes and experiences of older adults, ages 65 and up, when it comes to prescription drugs and related policy proposals being discussed. Experiences across different demographic groups are explored, such as household income and health status.
Three key private health insurance markets — Medicare Advantage, the individual market and the fully-insured group market — appear to be financially healthy and attractive to insurers. The private Medicare Advantage market generates significantly larger gross margins per person than the individual market or fully-insured market. The future of these markets has become a focus for policymakers amid the debate over Medicare for All.
As policymakers in Washington discuss ways to curb the rising cost of prescription drugs, KFF has released a summary and analysis of proposals and recently finalized initiatives that affect Medicare prescription drug spending. Medicare, the federal health program that covers more than 60 million seniors and younger people with disabilities,…
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.
The Medicare Part D prescription drug benefit has helped improve the affordability of medications for people with Medicare. Yet Part D enrollees can face relatively high out-of-pocket costs because the Part D benefit does not have a hard cap on out-of-pocket spending. This analysis presents the latest data on out-of-pocket drug spending among Medicare Part D enrollees without low-income subsidies who have costs above the catastrophic coverage threshold.
Medicare Advantage enrollment has grown rapidly over the past decade, and Medicare Advantage plans have taken on a larger role in the Medicare program. More than 22 million Medicare beneficiaries (34%) are enrolled in Medicare Advantage plans in 2019. This data note provides updated information about Medicare Advantage enrollment trends, premiums, and out-of-pocket limits. It also includes analyses of Medicare Advantage plans’ extra benefits and prior authorization requirements.
The analysis examines enrollment in Medicare Advantage plans during beneficiaries’ first year on Medicare and finds that less than one-third or 29% enrolled in these private health plans, including HMOs or PPOs. The majority of people new to Medicare are choosing traditional Medicare in the year they first go on Medicare. The study looks at how these findings vary across age, Medicaid status, states, and counties.