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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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  • Medicare Advantage 2010 Data Spotlight: Benefits and Cost-Sharing

    Issue Brief

    This data spotlight examines trends in benefits and cost-sharing for Medicare Advantage plans in 2010, including the wide variations found across plans and the rapid increase in cost sharing requirements for some benefits, including stays in skilled nursing facilities. It also examines the annual limits on out-of-pocket spending set by most Medicare Advantage plans and the availability of coverage for drugs in the Medicare drug benefit's coverage gap, or "doughnut hole." This data spotlight is…

  • Analysis of Medicare Prescription Drug Plans in 2011 and Key Trends Since 2006

    Report

    This report presents findings from an analysis of the Medicare Part D marketplace in 2011 and changes in drug coverage and costs since 2006. It presents key findings related to Medicare drug plan premiums, the subsidy for low-income beneficiaries, the coverage gap, benefit design and cost sharing, formularies, and utilization management, based on data from CMS for all plans participating in Part D. The analysis was conducted jointly by Jack Hoadley and Laura Summer of Georgetown…

  • Medicare Spending Cuts and Hospital Productivity Gains

    News Release

    In his latest column for The Wall Street Journal's Think Tank, Drew Altman and guest co-author Dana Goldman examine hospital productivity gains, and what they may mean for hospitals’ ability to absorb spending reductions. All previous columns by Drew Altman are available online.

  • Many More Counties Lack Medicare Advantage Plans Today than are at Risk for Lacking an ACA Marketplace Insurer in 2018

    News Release

    A new analysis from the Kaiser Family Foundation finds that 147 counties lack Medicare Advantage plans – many more than the 19 counties expected to lack an Affordable Care Act (ACA) marketplace insurer next year. Yet Medicare Advantage, the private plans that cover a third of all Medicare beneficiaries, is often described as an example of a robust insurance market, while some policymakers say the “bare” counties under the ACA are evidence that the law…

  • Lowering the Age of Medicare Eligibility Would Likely Reduce Health Spending for Employers, But Raise Costs for the Federal Government by Covering More People in Medicare

    News Release

    Two new KFF analyses find that lowering the age of Medicare eligibility from 65 to 60 could significantly reduce health spending for employers, who could potentially pass savings to employees in the form of lower premiums or higher wages. Additionally, per person health spending for older adults who move from employer coverage on to Medicare would likely be lower, though such moves would shift costs to taxpayers and increase Medicare program expenditures overall. President Biden…

  • Does Education Narrow the Gap in Wealth Among Older Adults, by Race and Ethnicity?

    Issue Brief

    This analysis of per capita income and assets among older adults in 2019 shows that differences in median per capita income among White, Black, and Hispanic adults ages 65 and older are narrower when comparing people with similar levels of education, although among college graduates, the gap in income continues to be wide between Hispanic and White seniors. The gaps in savings and home equity remain wide, and are particularly striking among seniors with less…

  • Addressing the Risk of Medicare Trust Fund Insolvency

    Perspective

    In this Viewpoint for the Journal of the American Medical Association (JAMA), KFF's Tricia Neuman and co-author Richard G. Frank of Harvard Medical School explain that the looming 2024 insolvency of the Medicare Hospital Insurance Trust Fund cannot be ignored for long.

  • A Status Report on Prescription Drug Policies and Proposals at the Start of the Biden Administration

    Issue Brief

    This brief provides a status update on prescription drug final rules advanced by the Trump Administration in its final months related to Medicare, importation, and 340B pricing for insulin and epinephrine, and an overview of key drug pricing proposals related to Medicare and prescription drug prices generally that were voted on but not enacted in the previous Congress that may return to the forefront of health policy discussions in the coming years.

  • March 30 Web Event: Unsung Heroes: The Crucial Role – and Tenuous Circumstances – of Home Care Workers During the Pandemic

    Event Date:
    Event

    Even as the pandemic took a devastating toll on health care workers and older adults in the United States, many home care workers continued to report to work and provide vital care to vulnerable people despite the health risks to themselves and their own families. KFF’s Kaiser Health News and The John A. Hartford Foundation held an interactive web event on March 30 to examine the crucial roles home care workers have played for families during…

  • COVID-19 Has Claimed the Lives of 100,000 Long-Term Care Residents and Staff

    Policy Watch

    More than 100,000 residents and staff have died in long-term care facilities since the start of the pandemic. This post discusses the implications of the likely rise in cases due to holiday gatherings and the share of total COVID-19 deaths that have happened in long-term care facilities.