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Cost-Sharing Subsidies in Federal Marketplace Plans, 2016

This brief and the accompanying slides examine reduction of cost sharing – deductibles, copayments and coinsurance – in the Affordable Care Act’s (ACA) federally-facilitated marketplaces in 2016. The analysis shows how cost-sharing subsidies reduce the cost of deductibles, out-of-pocket limits, physician visits, emergency room visits and prescription drug costs in silver plans for low-income people (people whose income is 250 percent of the federal poverty level or below).

Patient Cost-Sharing in Marketplace Plans, 2016

This brief and accompanying slides examine cost sharing – deductibles, copayments and coinsurance – in 2016 insurance plans sold on the Affordable Care Act’s (ACA) federally-facilitated marketplaces. The analysis looks at out-of-pocket limits, as well as cost sharing for hospital stays, physician visits, emergency room visits, and prescription drugs, for plans across the metal levels (platinum, gold, silver and bronze).

What’s in Store for Medicare’s Part B Premiums and Deductible in 2016, and Why?

As a result of the recently-enacted Bipartisan Budget Act of 2015, the Medicare Part B monthly premium will be $121.80 in 2016 according to the Centers for Medicare and Medicaid Services, an increase of 16 percent over the 2015 amount for 30 percent of beneficiaries —far lower than the 52 percent increase initially projected by the Medicare actuaries. This Issue Brief reviews how Medicare Part B premiums and deductibles are affected by the recent budget deal (including the premium surcharge that covers the costs) and explains the connection between the Social Security cost-of-living adjustment (COLA), Medicare premiums, and the “hold harmless” provision that will keep premiums flat for 70 percent of beneficiaries in 2016.

Round 2 on the Legal Challenges to Contraceptive Coverage: Are Nonprofits “Substantially Burdened” by the “Accommodation”?

The Affordable Care Act (ACA) requires most private health insurance plans to provide coverage for a broad range of preventive services including Food and Drug Administration (FDA) approved prescription contraceptives and services for women. Since the implementation of the ACA contraceptive coverage requirement in 2012, over 200 corporations have filed lawsuits claiming that including coverage for contraceptives or opting for an “accommodation” from the federal government violates their religious beliefs. This brief explains the legal issues raised by the nonprofit litigation and discusses the impact of the Hobby Lobby decision on the current litigation.

Understanding Health Insurance

The YouToons help consumers understand health insurance by explaining health insurance premiums, out-of-pocket costs, and provider networks. These three videos are excerpts from the 2014 YouToons video, Health Insurance Explained – The YouToons Have It Covered.

Medicare Part D at Ten Years: The 2015 Marketplace and Key Trends, 2006-2015

Since 2006, Medicare beneficiaries have had access through Medicare Part D to prescription drug coverage offered by private plans, either stand-alone prescription drug plans (PDPs) or Medicare Advantage prescription drug plans (MA-PD plans). Now in its tenth year, Part D has evolved due to changes in the private plan marketplace and the laws and regulations that govern the program. This report presents findings from an analysis of the Medicare Part D marketplace in 2015 and changes in features of the drug benefit offered by Part D plans since 2006.

2015 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 2015 EHBS survey finds average family health premiums rose 4 percent in 2015, relatively modest growth by historical standards.

Web Briefing for Media: 2015 Kaiser/HRET Employer Health Benefits Survey

The Kaiser Family Foundation and the Health Research & Educational Trust (HRET) hosts an annual reporters-only web briefing to release the 2015 Kaiser/HRET Employer Health Benefits Survey. The 17th annual Kaiser/HRET survey provides a detailed look at the current state of employer-based coverage and trends in private health insurance, including premiums, worker and employer contributions, firm offer rates, plan deductibles, and other cost-sharing requirements, with breakouts for small and large firms.