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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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Visualizing Health Policy: Physicians and Medicare

This infographic illustrates information about Medicare’s payment formula for physicians and about access to health care for people covered by Medicare.

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The Henry J. Kaiser Family Foundation

Medigap Reform: Setting the Context for Understanding Recent Proposals

This brief presents the most current data available on the Medicare supplemental insurance (Medigap) market, including enrollment and premiums by state and plan type, analyzes how many beneficiaries have first dollar coverage (particularly Plans C and F), and describes recent Medigap proposals that have emerged as part of efforts to reduce Medicare spending and the national debt.

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The Henry J. Kaiser Family Foundation

Raising Medicare Premiums for Higher-Income Beneficiaries: Assessing the Implications

As policymakers consider ways to slow the growth in Medicare spending as part of broader efforts to reduce the federal debt or offset the cost of other spending priorities, some have proposed to increase beneficiary contributions through higher Medicare premiums. This issue brief explains provisions of current law that impose income-related premiums under Medicare Part B and Part D, describes recent proposals to modify these requirements, and analyzes the potential implications for the Medicare population.

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The Henry J. Kaiser Family Foundation

Healthier and Wealthier, or Sicker and Poorer? Prospects for Medicare Beneficiaries Now and in the Future

This January 2014 briefing, co-sponsored by the Kaiser Family Foundation and the Alliance for Health Reform, examines what is known about the health and economic security of Medicare beneficiaries today, as well as how current and future beneficiaries may be affected by the leading proposals that aim to achieve Medicare savings.

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The Henry J. Kaiser Family Foundation

Medicare and the Federal Budget: Comparison of Medicare Provisions in Recent Federal Debt and Deficit Reduction Proposals

This brief provides a side-by-side comparison of Medicare provisions included in broad-based packages to reduce the deficit and debt put forward by the President and the Chairmen of the House and Senate Budget Committees. In addition, this brief summarizes Medicare provisions included in other deficit- and debt- reduction proposals released since January 2012 and describes recent activities that pertain to Medicare and the federal budget, including Medicare’s role in the Affordable Care Act (ACA), the fiscal cliff and sequestration.

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The Henry J. Kaiser Family Foundation

Income and Assets of Medicare Beneficiaries, 2013 – 2030

This data spotlight, co-authored by researchers at the Kaiser Family Foundation and the Urban Institute, describes the income, savings, and home equity of current Medicare beneficiaries, considers variations by race, ethnicity and other demographic characteristics, and examines the extent to which income and assets are projected to be higher among the next generation of beneficiaries.

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The Henry J. Kaiser Family Foundation

Health Care on a Budget: The Financial Burden of Health Spending by Medicare Households

The Medicare program offers health and financial protection to nearly 50 million seniors and younger people with disabilities, though many beneficiaries still face significant out-of-pocket expenses. This analysis examines how much Medicare households spend on health-related expenses compared to other spending priorities and compared to non-Medicare households, the extent to which Medicare households’ health spending as a share of household budgets varies by age and poverty level, and changes in Medicare households’ health spending over time.

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Webinar for Journalists: A Year-End Update on the ACA Rollout & Looking Ahead to 2014

Two and an half months into the open enrollment period for the Affordable Care Act, where does the rollout of the law stand with marketplace coverage set to begin on January 1, 2014? Featuring two Kaiser Family Foundation experts–Larry Levitt, Co-Director of the Foundation’s Program for the Study of Health Reform and Private Insurance & Senior Vice President, and Jennifer Tolbert, State Health Policy Director–the webinar touched on some of the major questions as people start using ACA coverage and the end of the open enrollment period on March 31. Most of the hour was devoted to a question and answer session with the participating audience.

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