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Medicare Part D 2008 Data Spotlight: The Coverage Gap

This Medicare Part D data spotlight examines the coverage gap, or “doughnut hole,” in Medicare drug plans available in 2008. Part D enrollees (other than those receiving low-income subsidies) will reach the coverage gap after they incur $2,510 in total drug costs in 2008. At that point, enrollees are required…

The Sleeper in Health Reform: Long-Term Care and the CLASS Act

The Kaiser Family Foundation briefing examines a little-noticed but major provision in two leading health reform bills that would change the way that the U.S. pays for long-term care. The provision, known as the Community Living Assistance Services and Supports (CLASS) Act, would establish a national voluntary insurance program that…

Medicaid: A Primer on the Federal-State Partnership

This briefing provided an overview of the Medicaid program and its role in the health care system. Panelists discussed who is eligible for Medicaid, what benefits are covered, how the program is administered. Medicaid financing and the program’s role in health reform was also explained. More information on Medicaid from…

Analysis of Medicare Prescription Drug Plans In 2012 And Key Trends Since 2006

This report presents findings from an analysis of the Medicare Part D marketplace in 2012 and changes in drug coverage and costs since 2006. It presents key findings related to Medicare drug plan plan availability, premiums, cost-sharing, the coverage gap and availability for low-income beneficiaries, the coverage gap, benefit design…

Quick Take: Essential Health Benefits: What Have States Decided for Their Benchmark?

Beginning on January 1, 2014, the Affordable Care Act (ACA) requires that all non-grandfathered individual and small group health insurance plans sold in a state, including those offered through an Exchange, cover certain essential health benefits (EHBs). As it stands today, many plans offered in the individual and small group…

Implementing New Private Health Insurance Market Rules

With the Jan. 1, 2014 effective date for implementing major changes in the private insurance market under the Affordable Care Act (ACA) approaching, this brief looks at three proposed federal regulations released in late November 2012 that detail how the ACA’s rules will operate in the following areas: private insurance…

Workplace Wellness Programs, Healthy Behaviors and Health Reform

Many large employers offer financial incentives to their employees to exercise regularly, improve their diets, lose weight and quit smoking. Health reform proposals would write some of these incentives into law. But some patient advocates say that, depending on how the incentives are structured, they can make coverage more expensive…

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…

Uniform Coverage Summaries for Consumers

This brief explains the proposed federal rule that requires private health plans to provide a short, easy-to-read uniform summary of benefits and coverage to all health insurance applicants and enrollees. The rule, which implements a provision in the Affordable Care Act (ACA), is intended to make it simpler for consumers…