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TrumpRx: What’s the Value for Customers?

In February, the Trump administration launched TrumpRx, a government website that provides prescription drug discounts to consumers. This brief examines issues that may impact consumers, especially those with private insurance, who access drug discounts through TrumpRx.

Claims Denials and Appeals in ACA Marketplace Plans in 2024

This brief analyzes federal transparency data published by CMS on claims denials and appeals for Marketplace plan offered on HealthCare.gov in 2024, and finds insurers denied 19% of in-network claims. Consumers rarely appeal denied claims.

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  • How Pending Health-Related Lawsuits Could be Impacted by the Incoming Trump Administration

    Issue Brief

    This brief provides an overview of current lawsuits in health policy including preventive services, abortion care, gender affirming care, Medicare drug price negotiations, nursing home staffing rules, private coverage consumer protections, and protections and health coverage for Deferred Action for Childhood Arrivals (DACA) recipients; how they may be affected by the incoming Trump administration; and the implications of their potential outcomes.

  • Copay Adjustment Programs: What Are They and What Do They Mean for Consumers?

    Issue Brief

    Drug makers sometimes offer copay coupons to lower consumers’ out-of-pocket costs for their brand-name prescriptions, though how private health plans treat those coupons can substantially limit their value to consumers. This issue brief provides an overview of such copay adjustment programs, stakeholder arguments for and against their use, their prevalence, and federal and state efforts to address them.

  • North Carolina’s Effort to Relieve Medical Debt

    Policy Watch

    This policy watch examines the burden of medical debt in North Carolina and the state’s new plan to leverage the Medicaid program to provide debt relief and support access to care for low- and middle-income North Carolinians.

  • Medical Debt: The Canary in the Coal Mine for Health Care Affordability

    Perspective

    With Vice President Harris promising to address medical debt as part of her economic plan, KFF Executive Vice President for Health Policy Larry Levitt explores why it is a symptom of the broader problem of affordable health care and reviews recent efforts to address it in this JAMA Health Forum post.

  • How Narrow or Broad Are ACA Marketplace Physician Networks?

    Report

    This report examines the share of doctors participating in the provider networks of Qualified Health Plans (QHPs) offered in the individual market in the federal and state Marketplaces in 2021, and how network breadth affected costs for enrollees.

  • What are the Consequences of Health Care Debt Among Older Adults?

    Issue Brief

    Health care debt is a widespread problem in the United States. Medicare offers coverage for a range of health care services, including hospitalizations, physician visits, prescription drugs, and post-acute care, but Medicare beneficiaries generally pay out-of-pocket for their monthly premiums and deductibles, cost-sharing for Medicare-covered services, and the cost of services not covered by Medicare. This data note examines findings from the KFF Health Care Debt Survey to assess the prevalence, sources and consequences of health care debt among Medicare-age adults.

  • Supreme Court Decision Limiting the Authority of Federal Agencies Could Have Far-Reaching Impacts for Health Policy

    Issue Brief

    On June 28, 2024, the U.S. Supreme Court overturned a longstanding legal precedent that required federal courts to defer to reasonable agency interpretation when statutes are ambiguous. The decision will shift many policy decisions from federal agencies to federal judges, with implications for health policy that will reverberate for years to come. This issue brief examines the decision and assesses what’s ahead.

  • The Implications of the Public’s Pre-existing Condition Amnesia

    Perspective

    KFF’s Larry Levitt discusses waning awareness of the Affordable Care Act’s provisions protecting people with pre-existing conditions and examines the Republican Study Committee's budget proposal, which proposes to repeal the provisions.