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How Much Is Enough? Out-of-Pocket Spending Among Medicare Beneficiaries: A Chartbook

This new analysis and chartbook examines out-of-pocket spending among Medicare beneficiaries, including spending on health and long-term care services and insurance premiums, using the most current year of data available from a nationally representative survey of people on Medicare. It explores which types of services account for a relatively large share of out-of-pocket spending, which groups of beneficiaries (including by age, gender, health status, and chronic conditions) are especially hard hit by high out-of-pocket costs, and trends in out-of-pocket spending between 2000 and 2010.

Abortion Coverage in Marketplace Plans, 2015

This brief analyzes state policies and insurer coverage decisions affecting the availability of abortion coverage in 2015 insurance plans offered through the Marketplaces. It finds that abortion coverage is unavailable in a total of 31 states, 24 of which have enacted laws that ban or restrict abortion coverage in plans sold through their Marketplaces and 7 of which have no abortion coverage restrictions but also have no Marketplace plans offering it.

Federal and State Standards for “Essential Community Providers” under the ACA and Implications for Women’s Health

Safety net providers such as community health centers and family planning clinics have served a significant role in the provision of primary care and reproductive health care services to low-income and uninsured people, particularly women. The Affordable Care Act (ACA) has a provision aimed at assuring that newly-insured individuals, as well as those without coverage, can continue seeing their trusted safety net providers, also called Essential Community Providers (ECPs). This brief reviews the definition of ECPs, examines the federal and state rules that govern the extent to which plans must include these providers in their networks, identifies the variation from state to state, and discusses the particular importance of these rules and providers for women’s access to care.

Consumer Assets and Patient Cost Sharing

Higher cost sharing in private insurance has been credited with helping to slow the growth of health care costs in recent years. For families with low incomes or moderate incomes, however, high deductibles, out-of-pocket limits and other cost sharing can be a potential barrier to care and may lead these families to significant financial difficulties. This issue brief uses information from the Federal Reserve Board’s 2013 Survey of Consumer Finances to look at how household resources match up against potential cost-sharing requirements for plans offered by employers or available in the individual market, including in the Affordable Care Act marketplaces.

How Much (More) Will Seniors Pay for a Doc Fix?

In this Policy Insight, the Foundation’s Cristina Boccuti and Tricia Neuman examine how Congress’ effort to permanently stave off scheduled cuts in Medicare’s physician payments could affect what Medicare beneficiaries pay for their care — both in premiums and in other potential changes — to offset the cost of the Sustainable Growth Rate (SGR) “doc fix.”

Insurance Markets in a Post-King World

This perspective addresses how insurance markets might respond if the US Supreme Court sides with the plaintiffs in the King v. Burwell case. The case challenges the legality of premium and cost-sharing subsidies for low- and middle-income people buying insurance in states where the federal government rather than the state is operating the marketplace under the Affordable Care Act (ACA).

Health Care Costs: What You Need To Know

On Wednesday, April 1, the Kaiser Family Foundation and the Alliance for Health Reform presented a briefing to explore the trends in health care costs in both the public and private sectors.

The Henry J. Kaiser Family Foundation Headquarters: 2400 Sand Hill Road, Menlo Park, CA 94025 | Phone 650-854-9400
Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270

www.kff.org | Email Alerts: kff.org/email | facebook.com/KaiserFamilyFoundation | twitter.com/KaiserFamFound

Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.