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Quick Take: CMS Extends Medicare’s Short-Term Bridge Program for GLP-1 Obesity Drug Coverage

CMS's temporary program to cover GLP-1 drugs for obesity in Medicare, called the BALANCE model, will not launch as scheduled on January 1, 2027. Instead, CMS is extending the Medicare GLP-1 Bridge, a separate short-term program that was to run from July to December 2026. It will now run through the end of 2027.
Also: What to Know About the BALANCE Model for GLP-1s in Medicare and Medicaid

Key Facts About Medicare Drug Price Negotiation

Recent Trends in GLP-1 Use and Spending in Medicare

What to Know About Pharmacy Benefit Managers (PBMs) and Federal Efforts at Regulation

The IRA Has Improved Coverage of Drugs Selected for Medicare Price Negotiation

NEW AND NOTEWORTHY

What to Know About Medicare Coverage of Telehealth

Congress has repeatedly extended pandemic-era flexibilities around Medicare coverage of telehealth, but most such flexibilities remain temporary. This brief answers key questions about the current scope of Medicare telehealth coverage, including both temporary and permanent changes adopted through legislation and regulation, and future policy considerations.

Changes to the Medicare Advantage Program Enhance Some Consumer Protections But Roll Back Others

CMS recently finalized policies as part of the 2027 Medicare Advantage final rule that both enhance consumer protections and roll back changes to the Medicare Advantage program that were intended to protect consumers. These changes have gotten less attention than payment issues and changes to the star ratings system, which also affect plan payments, but could have implications for Medicare beneficiaries.

Examining the Potential Impact of Medicare’s New WISeR Model

A federal initiative to establish new prior authorization requirements in traditional Medicare, called the Wasteful and Inappropriate Service Reduction (WISeR) model, is likely to have only modest impact in its first year.

State Profiles for Dual-Eligible Individuals

This data collection draws on Medicare and Medicaid administrative data to present national and state-level information on people who are covered by both Medicare and Medicaid, referred to as dual-eligible individuals (also known as dually-enrolled beneficiaries).

Medicare Advantage

Medicare Advantage Enrollment Grew by About 1 Million People, Mainly Due to Special Needs Plans

Medicare Advantage enrollment rose to 35.1 million people as of Feb. 1, an increase of 1.1 million since February 2025. The 3% uptick belied Medicare Advantage insurers’ projections that overall enrollment would decline compared to 2025. It was the lowest annual percentage increase in two decades.
The latest increase was largely driven by rising enrollment in Medicare Advantage Special Needs Plans (SNPs), which accounted for 83% of enrollment gains in 2026. However, three of the five largest Medicare Advantage insurers, including market leader UnitedHealth Group, Inc., experienced overall Medicare Advantage enrollment declines.

How Medicare Pays Medicare Advantage Plans: Issues and Policy Options

Medicare Advantage Enrollees Have Access to About Half of the Physicians Available to Traditional Medicare Beneficiaries

Medicare Advantage Insurers Made Nearly 53 Million Prior Authorization Determinations in 2024

Most Medicare Beneficiaries Affected by Plan Terminations in 2025 Have Robust Medicare Advantage Options in 2026

Medicare Part D

Analyzing Changes in Medicare Part D Enrollment for 2026

Analysis of CMS data shows that 56.1 million people have Medicare Part D drug coverage as of Feb. 2026, with 56% of enrollees in Medicare Advantage plans with drug coverage (MA-PDs) and 44% in stand-alone prescription drug plans (PDPs.)PDP enrollment increased, mainly due to the rise in enrollment in group employer/union plans for retirees.

Between 2025 and 2026, enrollment in group Medicare Advantage drug plans dropped for the first time since 2010, while group PDP enrollment rose by the largest amount Since 2013.

Premiums Are Decreasing for Many Stand-Alone Part D Drug Plans in a Number of States in 2026

Stand-Alone Drug Plans Cover a Larger Share of Part D Enrollees Living in the Most Rural Areas Than Medicare Advantage Plans

A Current Snapshot of the Medicare Part D Prescription Drug Benefit

Changes to Medicare Part D in 2024 and 2025 Under the Inflation Reduction Act and How Enrollees Will Benefit

Data Visualization

The Facts About Medicare Spending

This interactive provides the facts on Medicare spending. Medicare, which serves 67 million people and accounts for 12 percent of the federal budget and 21 percent of national health spending, is often the focus of discussions about health expenditures, health care affordability and the sustainability of federal health programs. u003cbru003eu003cbru003eExplore data on enrollment growth, Medicare spending trends overall and per person, growth in Medicare spending relative to private insurance, spending on benefits and Medicare Advantage, Part A trust fund solvency challenges, and growth in out-of-pocket spending by beneficiaries.u003cbru003eu003cbru003eu003ca href=u0022https://www.kff.org/medicare/issue-brief/faqs-on-medicare-financing-and-trust-fund-solvency/u0022 data-type=u0022linku0022 data-id=u0022https://www.kff.org/medicare/issue-brief/faqs-on-medicare-financing-and-trust-fund-solvency/u0022u003eRelated:u003ca href=u0022https://www.kff.org/medicare/issue-brief/faqs-on-medicare-financing-and-trust-fund-solvency/u0022u003e FAQs on Medicare Financing and Trust Fund Solvencyu003c/au003eu003c/au003e

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Medicare Open Enrollment

Beneficiaries Have 32 Medicare Advantage Prescription Drug Plans Available, on Average, for 2026

The average Medicare beneficiary will be able to choose among 32 Medicare Advantage plans with prescription drug coverage for 2026, two fewer than in 2025. The number of MA-PD options has grown steadily since 2010, peaking in 2024 when the average Medicare beneficiary had 36 options. Open enrollment runs October 15 through December 7.

Also: Medicare Open Enrollment FAQs

Premiums Are Decreasing for Many Stand-Alone Drug Plans in a Number of States in 2026

A Current Snapshot of the Medicare Part D Prescription Drug Benefit

The Role of SHIPs in Helping People with Medicare Navigate Their Coverage

What to Know About the Medicare Open Enrollment Period and Medicare Coverage Options

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  • Toplines: December 2005 Kaiser Health Poll Report

    Poll Finding

    Toplines: December 2005 Kaiser Health Poll Report These toplines provide the complete survey questions and responses to the December 2005 Kaiser Health Poll Report Survey, a bimonthly survey designed to provide key tracking information on public opinion about health care topics. The survey includes a series of questions on seniors' views of the new Medicare prescription drug benefit. Survey Toplines (.pdf)

  • Resources on Dual Eligibles and Issues Related to Their Transition to the New Medicare Drug Benefit

    Event Date:
    Event

    With the new Medicare prescription drug benefit available as of January 1, 2006, over 6 million low-income seniors and people with disabilities who are enrolled in both Medicaid and Medicare—also known as dual eligibles—have been transitioned from Medicaid drug coverage to new Medicare drug plans. While there are many policy issues related to the overall establishment of the new drug benefit, the mandatory transition of dual eligibles has created a special set of challenges for…

  • Insights on Transitioning From Medicaid to the New Medicare Prescription Drug Benefit

    Report

    The Kaiser Commission on Medicaid and the Uninsured convened a focus group of state Medicaid officials in November 2005 to discuss the impact of the new Medicare drug program on states and Medicaid enrollees. State insights on the transition of dual eligibles and some beneficiary experiences are discussed in new material and an audio briefing. Podcast: December 19, 2005 Conference Call Briefing (Downloadable Audio File) Presentations from the December 19, 2005 Conference Call Briefing (.pdf)…

  • An Implementation Perspective on Part D, the Medicare Prescription Drug Program

    Report

    This focus group of 12 state Medicaid officials conducted in November 2005 explores the current status and likely results of the Part D dual eligible transition efforts as well as other Part D-related issues of particular importance to states. It includes discussion of the transition of dual eligibles from Medicaid to Medicare drug coverage, evaluating Part D plan options, states’ role in the low-income subsidy program, the fiscal implications of Part D to states, and…

  • Prospects for Retiree Health Benefits as Medicare Drug Coverage Begins

    Poll Finding

    Findings from the Kaiser/Hewitt 2005 Survey on Retiree Health Benefits The 2005 Kaiser/Hewitt survey of large businesses that provide retiree health benefits to their workers assesses their responses to the new Medicare drug benefit in 2006, their plans for the future, and the way these changes affect retirees. It also looks at the rising costs and changing benefits of retiree health coverage overall in 2005. News Release Report Chartpack Materials from the December 7, 2005…

  • Prospects for Retiree Health Benefits as Medicare Drug Coverage Begins – Chartpack

    Report

    Prospects for Retiree Health Benefits as Medicare Drug Coverage Begins:Findings from the Kaiser/Hewitt 2005 Survey on Retiree Health Benefits - Chartpack This chartpack presents key data from the 2005 Kaiser/Hewitt survey of large businesses that provide retiree health benefits to their workers. Chartpack (.pdf)

  • Prospects for Retiree Health Benefits as Medicare Drug Coverage Begins – Report

    Report

    Prospects for Retiree Health Benefits as Medicare Drug Coverage Begins:Findings from the Kaiser/Hewitt 2005 Survey on Retiree Health Benefits - Report This report assesses how large businesses that provide retiree health benefits to their workers are responding to the new Medicare drug benefit in 2006, their plans for the future, and the way these responses affect retirees. It also looks at the rising costs and changing benefits of retiree health coverage overall in 2005. Full…

  • A Profile of African Americans, Latinos, and Whites with Medicare:

    Report

    This chartpack highlights demographic data about African Americans, Hispanics and whites with Medicare to highlight potential implications for outreach efforts under the new Medicare drug benefit. The information is being used in a series of November 2005 briefings at the start of the first open-enrollment period for the new benefit. Chartpack (.pdf)

  • Hispanics and the New Medicare Drug Benefit

    Poll Finding

    In a few short weeks, Medicare will undergo big changes that will have a major impact on more than 3 million Hispanic seniors and younger people with permanent disabilities who rely on Medicare for their health coverage. More than one in three Hispanics with Medicare lack coverage for their prescription drugs for at least part of the year. Many others will need to make decisions about their existing coverage and the new Medicare benefit. Starting…