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The Medicare Part D program provides an outpatient prescription drug benefit to 56 million older adults and people with long-term disabilities in Medicare who enroll in private plans. This brief analyzes Medicare Part D enrollment, premiums, and cost sharing in 2026 and trends over time, based on data from the Centers for Medicare & Medicaid Services (CMS).
This fact sheet reviews major sources of coverage for women residing in the U.S. in 2024, discusses the impact of the ACA on women’s coverage, and the coverage challenges that many women continue to face.
This brief provides information about Medicare Advantage plans in 2026, including premiums, out-of-pocket limits, supplemental benefits, and prior authorization, as well as trends over time.
This brief examines recent state trends in Medicaid behavioral health coverage and payment and state coverage of select treatment models for people with serious mental illness—a population that has historically faced significant barriers to care. This includes details about coverage of Certified Community Behavioral Health Clinics (CCBHCs) (as a provider type), Assertive Community Treatment (ACT), and Coordinated Specialty Care for First Episode Psychosis (CSC-FEP).
This Health Policy 101 chapter explores employer-sponsored health insurance (ESI), the primary health coverage source for U.S. residents under age 65. In addition to detailing ESI requirements and incentives, structure, availability, and costs, the chapter examines ongoing challenges related to affordability and access to care for those with ESI coverage.
The Trump administration this week backed off a key element of its Medicare Advantage rate proposal, resulting in billions of dollars in additional payments to private insurers.
This issue brief examines California's Medicaid work requirement implementation plans to provide initial insight into how California is preparing to implement work requirements amid projected state budget shortfalls and changes in the 2025 reconciliation law.
Medicaid represents $1 out of every $5 spent on health care in the U.S. and is the major source of financing for states to provide health coverage and long-term services and supports for low-income residents. This brief examines key questions about Medicaid financing and how it works.
The Medicare drug price negotiation program could improve coverage of drugs selected for negotiation for Medicare beneficiaries because the law requires all Medicare Part D plans to cover each of the selected drugs, including all dosages and forms, when negotiated prices take effect. This analysis examines 2026 Medicare Part D formulary coverage of drugs selected for negotiation to measure the effect of the IRA's coverage requirement.
This brief describes current state fiscal conditions as states begin fiscal year 2027 budget debates and highlights key areas to watch for Medicaid policy changes as states respond to fiscal challenges and the 2025 reconciliation law.
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