Major Differences in the BBA Medicaid Managed Care Regulation
A side-by-side comparison of the original and revised Federal rule for new consumer protection and quality assurance requirements for Medicaid managed care.
Medicare
Medicare Advantage
Medicare Advantage in 2025: Enrollment Update and Key Trends
In 2025, more than half (54%) of eligible Medicare beneficiaries - 34.1 million out of about 62.8 million with both Medicare Parts A and B - are enrolled in Medicare Advantage plans. The Congressional Budget Office projects that the share will rise to 64% by 2034.
One in five (21%) Medicare Advantage enrollees is in a special needs plan (SNP), reflecting a steady increase in recent years. Overall, Medicare Advantage enrollment is highly concentrated among plans owned by a few firms.
Also: Medicare Advantage in 2025: Premiums, Out-of-Pocket Limits, Supplemental Benefits, and Prior Authorization
One in five (21%) Medicare Advantage enrollees is in a special needs plan (SNP), reflecting a steady increase in recent years. Overall, Medicare Advantage enrollment is highly concentrated among plans owned by a few firms.
Also: Medicare Advantage in 2025: Premiums, Out-of-Pocket Limits, Supplemental Benefits, and Prior Authorization
New & Noteworthy
Medicare Provisions in the 2025 Budget Reconciliation Law
This summary provides background, description, budgetary impact and related information on the Medicare provisions in the 2025 federal budget reconciliation law, previously known as the "One Big Beautiful Bill."Health Costs Consume a Large Portion of Income for People with Medicare
Out-of-pocket health care spending by Medicare beneficiaries accounted for 39% of Social Security income per person in 2022, on average. This brief analyzes out-of-pocket health care costs as a share of Social Security income and total income.Income and Assets of Medicare Beneficiaries in 2024
One in four Medicare beneficiaries – 16.5 million people with Medicare – lived on incomes below $24,600 per person in 2024. A look at the income, assets, and home equity of Medicare beneficiaries.State Profiles for Dual-Eligible Individuals
This new database offers the latest national and state data and statistics on dual-eligible individuals who receive their primary health insurance coverage through Medicare and some assistance from their state Medicaid program.
Medicare PArt D
The Uncertain Future of Medicare's Stand-Alone PDP Market and Why It Matters
This brief discusses the uncertain future of Medicare’s Part D stand-alone prescription drug plan (PDP) market, in light of declining PDP availability, rising premiums, and the unknown fate of a temporary demonstration program designed to stabilize the market more broadly. The uncertain future of the market is especially relevant for rural areas, where nearly 6 in 10 beneficiaries are enrolled in traditional Medicare and PDPs, and where there are fewer Medicare Advantage options.
Prescription Drugs
The Effect of Delaying the Selection of Small Molecule Drugs for Medicare Drug Price Negotiation
Part of a recent executive order from President Trump directs the Secretary of HHS to work with Congress to implement a change in the Medicare Drug Price Negotiation Program to delay negotiation of so-called “small molecule” drugs beyond 7 years after FDA approval under current law. If that timeframe had already been in place, more than half of the Part D drugs that were selected for price negotiation in the first or second rounds – 13 out of 25 – would not have been eligible at the time drugs were selected.
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.
Explore 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.
Related: FAQs on Medicare Financing and Trust Fund Solvency
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