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Boomers Come of Age: Covering Early Retirees and Other 50-64 Year-Olds

The Patient Protection and Affordable Care Act contains provisions that can help workers age 50-64 if they lose their jobs and their employer-sponsored health benefits, such as incentives for employers to maintain retiree benefits. This briefing, cosponsored by the Alliance for Health Reform and AARP, answered many questions about provisions…

Medicare Prescription Drug Plans in 2009 and Key Changes Since 2006: Summary of Findings

Since 2006, Medicare beneficiaries have had access to prescription drug coverage offered by private plans, either stand-alone prescription drug plans (PDPs) or Medicare Advantage prescription drug plans (MA-PD plans). Today, more than 26 million Medicare beneficiaries are enrolled in Medicare drug plans, including 17.5 million in stand-alone prescription drug plans…

The Affordable Care Act’s Impact on Medicaid Eligibility, Enrollment, and Benefits for People with Disabilities

Medicaid is an important source of health insurance coverage for people with disabilities. This issue brief explains how Medicaid eligibility and benefits for people with disabilities are affected by the Affordable Care Act (ACA) rules as of 2014. Marketplace rules are discussed to the extent that they relate to Medicaid eligibility determinations for people with disabilities.

Retiree Health Benefits At the Crossroads

This issue brief reviews recent trends and developments in employer-sponsored retiree health coverage and examines the impact of recent legislation, such as the Medicare drug benefit and the Affordable Care Act (ACA) on retiree health coverage. The report describes leading strategies employers have been pursuing or considering to limit costs for retiree health benefits. In addition, the report considers the potential implications of proposals aimed at reducing federal spending for retiree health coverage and costs.

The Medicare Part D Coverage Gap: Costs and Consequences in 2007

This study quantifies the number of Medicare Part D plan enrollees in 2007 who reached a gap in their prescription drug coverage known as the “doughnut hole,” as well as the changes in beneficiaries’ use of medications and out-of-pocket spending after they reached that gap.

Medicaid: A Primer – Key Information on the Nation’s Health Coverage Program for Low-Income People

This primer provides an overview of Medicaid, the nation’s largest health coverage program, which covers more than 62 million low-income individuals, including children and families, people with disabilities and seniors who are also covered by Medicare. Medicaid also is the dominant source of the country’s long-term care financing. The program will expand significantly under the Affordable Care Act in 2014.

Medicare Part D 2010 Data Spotlight: Benefit Design and Cost Sharing

The Medicare Modernization Act established a defined standard drug benefit for Part D stand-alone Prescription Drug Plans (PDPs) and Medicare Advantage Prescription Drug (MA-PD) plans, while giving plans flexibility to offer alternative benefit designs. Only about one in 10 PDPs offer the standard benefit in 2010. Plan sponsors can offer…

The Role of Clinical and Cost Information in Medicaid Pharmacy Benefit Decisions: Experience in Seven States

This policy brief provides perspective on the potential for using comparative effectiveness research in Medicaid pharmacy programs by looking at seven states to determine how they currently evaluate relative clinical and cost information about prescription drugs when making coverage decisions for their Medicaid pharmacy benefits. The brief was prepared by…

Essential Health Benefits: Balancing Affordability and Adequacy

Under the Patient Protection and Affordable Care Act (PPACA), insurance plans offered through state insurance exchanges as well as non-grandfathered plans offered in the individual and small group markets – will be required to cover a set of health benefits and services called the “essential health benefits” package. Guidance issued…

Medicaid Enrollment and Expenditures by Federal Core Requirements and State Options

To receive federal Medicaid matching funds, states that participate in Medicaid must meet federal requirements, which include covering specified “federal core” enrollee groups and mandatory health benefits. States also may choose to cover additional “state expansion” enrollees and optional benefits with federal Medicaid matching funds. The federal core eligibility standards…