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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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  • Views of the New Medicare Drug Law – Toplines

    Poll Finding

    This document includes the toplines from a comprehensive survey of people on Medicare and their attitudes toward the new Medicare drug law. The survey provides detailed insight in their perceptions and opinions about the law, the Medicare-approved drug-discount card program and the new Medicare drug benefit set to begin in January 2006. It also assesses views on the law’s implications for the 2004 elections. Survey Toplines (.pdf)

  • The Transition of Dual Eligibles to Medicare Part D Prescription Drug Coverage: State Actions During Implementation

    Report

    This 50-state survey of Medicaid officials assesses states’ early experience relating to the transition of low-income seniors and people with disabilities enrolled in both Medicaid and Medicare (dual eligibles) to the Medicare Part D drug benefit. Conducted by Health Management Associates, the survey covers the types of problems observed by states during the transition of dual eligibles to the Medicare drug benefit, state actions to correct problems and ensure temporary coverage, and specific data on…

  • Oversight and Enforcement of Medicare Part D Plan Requirements:  Federal Role and Responsibilities

    Issue Brief

    Oversight and Enforcement of Medicare Part D Plan Requirements: Federal Role and Responsibilities This Issue Brief was commissioned by the Kaiser Family Foundation to gain insights into legal advocates’ views of how federal authorities enforce compliance with requirements of the new Medicare Part D prescription drug benefit. The report was prepared by Toby Edelman of the Center for Medicare Advocacy, Inc. The views expressed in this report are those of the author and not necessarily…

  • March/April 2005 Kaiser Health Poll Report – Toplines

    Poll Finding

    Health News Index March/April, 2005 The March/April Kaiser Health Poll Report featured topic explores the public's views on the Medicare prescription drug benefit. This featured topic covers the historical perspective from before the law was passed as well as current views and understanding of the benefit, including how seniors are getting information about this plan, whether they think they have enough information and whether or not they plan to enroll. Additionally, the featured topic explores…

  • Prescription Drug Procurement and the Federal Budget

    Issue Brief

    This brief commissioned by the Foundation considers areas where Medicare faces limited opportunity for market-based competition and price negotiation to drive down drug spending. These areas include drug purchasing for low-income people enrolled in Part D plans who face minimal cost-sharing requirements, and purchasing certain unique drugs, such as biologicals, that have no therapeutic alternatives or competitors. Authored by Richard G. Frank of Harvard University, the brief discusses policy options that could lower Medicare spending…

  • Medicare 2008 Benefits Table

    Report

    2008 Medicare Benefits Table Summary of Traditional Medicare, 2008 PART A Financing: 1.45% for both workers and employers No premiums* Benefits: Inpatient hospital - Days 1-60 - Days 61-90 - Days 91-150 - After 150 days Deductible of $1,024 per benefit period** No coinsurance $256 a day $512 a day No benefits Skilled nursing facility - Days 1-20 - Days 21-100 - After 100 days No coinsurance $128 a day No benefits Home health No…

  • Oral Health and Medicare Beneficiaries: Coverage, Out-of-Pocket Spending, and Unmet Need

    Issue Brief

    This brief describes the oral health of Medicare beneficiaries, examines sources of dental coverage for the Medicare population, and examines the utilization of dental services, out-of-pocket spending on dental care, and access problems. This analysis uses data from the National Health and Nutrition Examination Survey (NHANES), the Medicare Current Beneficiary Survey Cost and Use file (MCBS), the National Health Interview Survey (NHIS) and the Kaiser Family Foundation Survey of Health Care Among Nonelderly People with…

  • Kaiser Family Foundation/Harvard School of Public Health National Survey of the Public’s Views on Medicare

    Poll Finding

    Kaiser Family Foundation/Harvard School of Public Health National Survey of the Public's Views on Medicare A new national survey by the Kaiser Family Foundation and the Harvard School of Public Health examines the public's attitudes and opinions on issues related to the Medicare reform and prescription drug debate. The survey also takes a separate look at the differing views of younger and older Americans on this topic. Toplines/Survey (.pdf)

  • Key Facts About Medicare Drug Price Negotiation

    Issue Brief

    Under the Medicare Drug Price Negotiation Program, the federal government negotiates prices with drug companies for certain high-cost drugs covered under Medicare Part B and Part D. This brief provides information about several key aspects of the Medicare drug price negotiation program, with a focus on the 2028 implementation year.