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This document, prepared by Health Policy Alternatives, Inc., provides a detailed summary of the prescription drug provisions of the Medicare legislation (P.L. 108-173) signed by the President on December 8, 2003. Report (.pdf)
This document, prepared by Health Policy Alternatives, Inc., provides a detailed side-by-side comparison of the prescription drug provisions of the Conference Agreement (H.R. 1) passed by the House and Senate in November 2003 and the House (H.R. 1) and Senate (S. 1) Medicare proposals passed in June 2003. Report (.pdf)
State governments are an important source of health insurance coverage for retired state employees. Confronted with rising health care costs, budget deficits, and an overall downturn in the economy, this report describes how states are responding to the challenge of financing health care for retirees who tend to be sicker and more costly to cover than active workers. This study, based on survey responses from 43 states and the District of Columbia, captures information on…
Tricia Neuman, Vice President and Director of the Medicare Policy Project, testified on behalf of herself and Thomas Rice, Ph.D., of UCLA's School of Public Health, before the House Ways and Means Subcommittee on Health on cost-sharing requirements under Medicare and supplemental Medigap policies. The statement reviews Medicare beneficiaries' current cost-sharing responsibilities, the evidence on the impact of out-of-pocket costs on health-care utilization, and the implications for proposals that would modify Medicare's cost-sharing structure.
Understanding how Medicare+Choice (M+C) plans manage their drug benefits may generate important lessons for Medicare. This report, based on interviews with both national and regional managed care firms, provides an in-depth look at how plans have managed their M+C outpatient pharmacy benefits in recent years. Findings show that plans rely on a number of cost management strategies to constrain the growth in drug spending including formularies, tiered-copayments, mail-order benefits, and fixed caps or dollar limits…
Private Long-Term Care Insurance: Who Should Buy It and What Should They Buy? Despite the growing interest in private long-term care insurance (LTCI), there has been little independent examination of how much protection LTCI policies provide consumers or whether LTCI policies are a worthwhile purchase for people of average means. This report draws on data from the 1998 Survey of Consumer Finances (SCF) and the 1996 Medical Expenditures Panel Survey (MEPS) to explore the feasibility…
This report illustrates the financial stakes for Medicare beneficiaries when making choices about supplemental insurance coverage, by examining how much people on Medicare could spend out-of-pocket including premiums and other cost-sharing requirements under different supplemental insurance options. To assess the cost implications of choosing between different Medigap and Medicare+Choice insurance options, the research team estimated the range in health care expenditures associated with three prototypical beneficiaries (a 50 year-old man with disabilities, a relatively healthy…
This report presents findings from a study of large private-sector employers conducted by researchers at Hewitt Associates and the Kaiser Family Foundation between July and September of 2002. The study is based on survey responses of 435 large private-sector firms (1,000+ employees) that currently offer retiree health benefits, and includes 36% of all Fortune 100 companies and 28% of all Fortune 500 companies. Information was collected on a variety of topics including costs, premiums, retiree…
About 5 million Americans under age 65 qualify for Medicare coverage because they are totally and permanently disabled. They are more likely than the elderly to live in poverty, to be in poor health, and to experience difficulties living independently and performing basic daily tasks. A new study from The Commonwealth Fund and the Henry J. Kaiser Family Foundation, reports that the disabled have few options other than Medicaid for obtaining prescription coverage. In ,…
Thirty-five percent of all California Medicare beneficiaries are enrolled in a M+C plan, far in excess of the 14 percent rate nationwide. This report seeks to identify what lessons for the nation can be drawn from the California M+C experience, as Congress debates the implications of major withdrawals from the M+C program and potential policy changes aimed at reversing this trend. The report is based largely on analysis of M+C data on plan participation, withdrawals,…
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