Seniors - Research and Data from KFF

Millions of Medicare Part D Enrollees Have Had Out-of-Pocket Drug Spending Above the Catastrophic Threshold Over Time

Jul 23, 2021

Issue Brief

Medicare Part D, the outpatient prescription drug benefit for Medicare beneficiaries, provides catastrophic coverage for high out-of-pocket drug costs, but there is no limit on the total amount that beneficiaries have to pay out of pocket each year. Policymakers on both sides of the aisle support proposals to modify the design of the Part D benefit and establish a hard cap on out-of-pocket prescription drug spending by Part D enrollees. This analysis shows the number…

State Options to Expand Medicaid HCBS: Examples & Evaluations of Section 1115 Waivers

Jul 16, 2021

Issue Brief

States are currently developing plans to access an increased federal matching rate (“FMAP”) for Medicaid HCBS spending established in the American Rescue Plan Act (ARPA) of 2021. In the future, states may also be able to access increased HCBS funds proposed in the Biden Administration’s American Jobs Plan and the Better Care Better Jobs Act recently introduced in Congress. This brief highlights examples of Medicaid HCBS policy changes authorized through Section 1115 demonstration waivers in…

How Could $400 Billion New Federal Dollars Change Medicaid Home and Community-Based Services?

Jul 16, 2021

Issue Brief

This issue brief places the American Jobs Plan in the context of current Medicaid HCBS spending and considers how policymakers might allocate the new funding, as the proposal to date includes little detail.

Although Their Share of the Market Varies By State, Enrollment in Medicare Advantage Plans Has More Than Doubled Over the Past Decade, with More than 4 in 10 Medicare Beneficiaries Now Enrolled in the Private Plans

Jun 21, 2021

News Release

The private plans known as Medicare Advantage now cover more than 4 in 10 Medicare beneficiaries, reflecting a more than doubling of enrollment over the past decade even as the plans remain a far larger presence in some states than others, according to a new KFF analysis. More than 26 million of the nation’s nearly 63 million Medicare beneficiaries are enrolled in Medicare Advantage plans in 2021. The share varies considerably by state, ranging from…

How Might Lowering the Medicare Age Affect Medicaid Enrollees?

Jun 10, 2021

Issue Brief

This issue brief highlights key differences between Medicare and Medicaid and raises questions about how a policy to lower the age of Medicare eligibility could affect individuals who are currently enrolled in Medicaid.

FDA’s Approval of Biogen’s New Alzheimer’s Drug Has Huge Cost Implications for Medicare and Beneficiaries

Jun 10, 2021

Issue Brief

The question of what would happen when a new, expensive prescription drug comes to market for a disease like Alzheimer’s that afflicts millions of people has loomed large in discussions over drug prices in the U.S. This brief analyzes the cost implications for Medicare and beneficiaries associated with Biogen's new FDA-approved Alzheimer's drug, which will cost $56,000 per year.

Key Facts About Medicare Part D Enrollment, Premiums, and Cost Sharing in 2021

Jun 8, 2021

Issue Brief

The Medicare Part D program provides an outpatient prescription drug benefit to older adults and people with long-term disabilities in Medicare who enroll in private plans, including stand-alone drug plans and Medicare Advantage drug plans. This analysis provides the latest data about Part D enrollment, premiums, and cost sharing in 2021 and trends over time.

Potential Impact of Additional Federal Funds for Medicaid HCBS for Seniors and People with Disabilities

May 28, 2021

Issue Brief

The American Rescue Plan includes a provision to increase the federal matching rate (FMAP) for spending on Medicaid HCBS by 10 percentage points from April 1, 2021 through March 31, 2022 provided states maintain state spending levels as of April 1, 2021. This brief discusses the proposal and provides state by state estimates of the potential effects of the policy change. It was updated on May 28 to include key points from the new CMS…

Lowering the Age of Medicare Eligibility to 60 Could Reduce the Cost of Health Care and Have a Modest Effect on the Number of People Who Are Uninsured

May 21, 2021

News Release

A new KFF analysis shows that lowering the age of Medicare eligibility to 60 could improve the affordability of coverage for people who are already insured and expand coverage to over a million of the nation’s 30 million uninsured. Such a policy could provide a path to Medicare coverage for up to 11.7 million people with employer-based insurance and 2.4 million with private, non-group coverage who are ages 60 to 64, although it is unclear…

Coverage Implications of Policies to Lower the Age of Medicare Eligibility

May 21, 2021

Issue Brief

This data note looks at the coverage implications of policies to lower the age of Medicare eligibility as proposed by President Biden during the presidential campaign.

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