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The Henry J. Kaiser Family Foundation

Health Care Costs: A Primer

This primer on health care spending in the United States reviews the growth in health care spending since 1970 and the impact of health care costs on families and employers.

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The Henry J. Kaiser Family Foundation

Adding an Out-of-Pocket Spending Maximum to Medicare: Implementation Issues and Challenges

In an effort to simplify Medicare’s cost-sharing requirements, provide beneficiaries with catastrophic protection, and achieve program savings, some have proposed to restructure Medicare’s benefit design. Several recent proposals would create a unified deductible for Medicare Parts A and B, simplify cost-sharing requirements above the deductible, and add an annual limit on beneficiary out-of-pocket spending—a benefit feature typical of larger employer plans, but lacking in traditional Medicare. This issue brief describes the options for adding an out-of-pocket spending limit to Medicare and examines the operational issues that could arise in implementing both a uniform and an income-based out-of-pocket spending limit. Because the implementation of an income-related out-of-pocket maximum would pose somewhat greater complexity for Medicare, the operational issues associated with this approach are discussed in greater detail.

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The Henry J. Kaiser Family Foundation

Paying a Visit to the Doctor: Current Financial Protections for Medicare Patients When Receiving Physician Services

This issue brief explains provisions in current law that shield beneficiaries from unexpected and confusing charges when they see physicians and practitioners—namely, the participating provider program, limitation on balance billing, and conditions on private contracting for doctors who opt out of Medicare or join “concierge” practices. It also analyzes the implications of modifying these provisions for beneficiaries, providers, and the Medicare program.

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The Henry J. Kaiser Family Foundation

Medicare Part D Prescription Drug Plans: The Marketplace in 2013 and Key Trends, 2006-2013

This report presents findings from an analysis of the Medicare Part D marketplace in 2013 and changes in drug coverage and costs since 2006. It presents key findings related to Medicare drug plan availability, enrollment, premiums, low-income subsidies, the coverage gap, benefit design, cost sharing, formularies, and utilization management, based on data from CMS for all plans participating in Part D. The analysis was conducted jointly by researchers at Georgetown University, the Kaiser Family Foundation and the National Opinion Research Center at the University of Chicago.

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The Henry J. Kaiser Family Foundation

Explaining Health Reform: Benefits and Cost-Sharing for Adult Medicaid Beneficiaries

This brief provides details of the benefit and cost-sharing rules that will govern the coverage available under health reform to these newly eligible adults Medicaid beneficiaries, and it identifies key considerations for state policymakers making Medicaid benefit design choices.

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The Henry J. Kaiser Family Foundation

2013 Employer Health Benefits Survey

This annual Employer Health Benefits Survey (EHBS) provides a detailed look at trends in employer-sponsored health coverage, including premiums, employee contributions, cost-sharing provisions, and other relevant information. The 2013 EHBS survey finds average family health premiums rose 4 percent in 2013, relatively modest growth by historical standards.

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The Henry J. Kaiser Family Foundation

Medicaid Expansion through Premium Assistance: Key Issues for Beneficiaries in Arkansas’ Section 1115 Demonstration Waiver Proposal

This issue brief provides background about Medicaid premium assistance in the individual health insurance market, summarizes major components of Arkansas’ Section 1115 demonstration waiver application to implement the Affordable Care Act’s Medicaid expansion through premium assistance, and considers key issues affecting beneficiaries.

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The Youtoons Get Ready 300x200

The YouToons Get Ready for Obamacare: Health Insurance Changes Coming Your Way Under the Affordable Care Act

In this animated video, the YouToons get ready for Obamacare and explore health insurance changes under the Affordable Care Act. This cartoon serves as a health reform tutorial for consumers and organizations. The YouToons first appeared in the 2010 animated movie, “Health Reform Hits Main Street.”

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The Youtoons Get Ready 300x200

New Animation Explains Changes Coming for Americans Under Obamacare

A new animated video features the YouToons as they get ready for Obamacare and explore health insurance changes under the Affordable Care Act (ACA). The cartoon serves as a health reform tutorial for consumers and organizations.

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Streamlining Cost Sharing in Medicare: The Impact on Beneficiaries

This July 22, 2013 briefing, Streamlining Cost Sharing in Medicare: The Impact on Beneficiaries, explored the impact on beneficiaries of recent proposals to combine the two main parts of Medicare.

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