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Modifying Traditional Medicare’s Benefit Design Could Reduce Federal Spending But With Cost Tradeoffs Between Beneficiaries and The Federal Government

Revamping traditional Medicare’s benefit design and restricting “first-dollar” supplemental coverage could reduce federal spending, simplify cost sharing, protect against high medical costs, decrease out-of-pocket spending for many beneficiaries, and provide more help to those with low incomes — but would be unlikely to achieve all of these goals simultaneously.

Modifying Medicare’s Benefit Design: What’s the Impact on Beneficiaries and Spending?

This report examines an approach to reforming Medicare that has been a focus of Congressional hearings and featured in several broader debt reduction and entitlement reform proposals, and was included in the June 2016 House Republican health plan. The analysis models four different options for modifying Medicare’s benefit design, all of which include a single deductible, modified cost-sharing requirements, a new cost-sharing limit, and a prohibition on first-dollar Medigap coverage. The analysis models the expected effects on out-of-pocket spending by beneficiaries in traditional Medicare, and assesses how each option is expected to affect spending by the federal government, state Medicaid programs, employers, and other payers, assuming full implementation in 2018.

Overview of Medicaid Per Capita Cap Proposals

The House Republican Plan (“A Better Way”) released on June 22, 2016, includes a proposal to convert federal Medicaid financing from an open-ended entitlement to a per capita allotment or a block grant (based on a state choice). This proposal is part of a larger package designed to replace the Affordable Care Act (ACA) and reduce federal spending for health care. Often tied to deficit reduction, proposals to convert Medicaid’s financing structure to a per capita cap or block grant have been proposed before. Such changes represent a fundamental change in the financing structure of the program with major implications for beneficiaries, providers, states and localities. Key things to understand about a per capita cap include the following: how a per capita cap works, key design challenges, and implications of a per capita cap.

An Overview of Medicare

This issue brief provides an overview of Medicare, the health insurance program for people ages 65 and over and younger people with permanent disabilities. The brief review the characteristics of people on Medicare, what Medicare covers, benefit gaps and supplemental coverage, beneficiaries’ out-of-pocket health care spending, program spending and financing, payment and delivery system reform, and issues for the future of Medicare.

The U.S. Global Health Budget: Analysis of the Fiscal Year 2017 Budget Request

The President’s Fiscal Year 2017 (FY17) budget request, which was released on February 9, 2016, included $10.3 billion in total funding for global health programs. This marks the first time in three years that the request for global health is higher than the previous year enacted level, and represents the largest request since FY12. If enacted by Congress, it would represent the highest level of global health funding to date (excluding emergency funding for Ebola provided in FY15).

Searching for Savings in Medicare Drug Price Negotiations

In response to higher drug spending growth and heightened attention to drug prices, some policymakers and presidential candidates are proposing to allow Medicare to negotiate the price of prescription drugs. This issue brief provides a short history of this proposal, describes various approaches, and assessments of their potential savings from the Congressional Budget Office (CBO), and considers the prospects for action in the future.

Reading the Tea Leaves on U.S. Global Health Policy

In this Policy Insight, Jen Kates and Josh Michaud look at the prospects for the future of U.S. global health policy, examining whether long-term bipartisan support may be tested during a time of political transition, and identifying key areas of consensus among policymakers and the public.

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.