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

    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 guidance about how states can access the funds and examples of how funds can be used.

  • COVID-19 Long-Term Care Deaths and Cases Are at An All-Time Low, Though A Rise In LTC Cases In A Few States May Be Cause for Concern

    Issue Brief

    This data note looks at state-reported LTCF data from 41 states plus Washington DC to assess what has happened to new deaths and cases in LTCFs in the four months since vaccinations began on December 21st, 2020. We also examine how recent changes in deaths and cases in LTCFs have shifted the nature of the pandemic outside of LTCFs. Data in this analysis is as of the week of April 11th, 2021.

  • Medicare and Dental Coverage: A Closer Look

    Issue Brief

    Medicare does not cover routine dental care and about half of Medicare beneficiaries do not have dental coverage. Some beneficiaries have dental coverage through other sources, including Medicare Advantage, but 47% of all beneficiaries have not been to the dentist in the past year and many older adults face high out-of-pocket costs for needed dental care. This brief provides new data on the share of Medicare beneficiaries with dental coverage, the share with a dental visit in the past 12 months, and out-of-pocket spending on dental care. It also takes a closer look at the scope of dental benefits offered to Medicare Advantage enrollees in individual plans in 2021.

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

    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 of Part D enrollees without low-income subsidies who have exceeded the catastrophic coverage threshold annually, and over multiple years, based on 2007-2019 Part D claims data.

  • Explaining the Prescription Drug Provisions in the Inflation Reduction Act

    Issue Brief

    The Inflation Reduction Act includes several provisions that will lower prescription drug costs for people with Medicare and reduce drug spending by the federal government. This brief summarizes these provisions and discusses the expected effects on people, program spending, and drug prices and innovation.

  • Key Facts About Medicare Part D Enrollment and Costs in 2023

    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. This brief analyzes Medicare Part D enrollment and costs in 2023 and trends over time. The analysis highlights the substantial growth of Medicare Advantage drug plans in the marketplace for Part D drug coverage, where enrollment overall is concentrated in a handful of large plan sponsors.

  • Nursing Facility Staffing Shortages During the COVID-19 Pandemic

    Issue Brief

    This data note presents the most recent national and state-level data on nursing facility-reported staff shortages and describes the Biden Administration’s new policy initiatives to address staffing and other quality issues in nursing facilities.