Category: cost-sharing

New Rule Proposes Changes to ACA Coverage of Gender-Affirming Care, Potentially Increasing Costs for Consumers

This brief examines a proposed rule that seeks to change how ACA plans would cover gender affirming care services. If finalized the rule could lead insurers to drop coverage or shift costs to individuals and states, making access to gender affirming ca…

A Backlash Against Health Insurers, Redux

In this JAMA Health Forum post, Executive Vice President Larry Levitt recalls the mid-1990s’ public backlash against Health Maintenance Organizations (commonly known as HMOs) – all of which preceded the recent outpouring of health insurance concerns –…

Copay Adjustment Programs: What Are They and What Do They Mean for Consumers?

Drug makers sometimes offer copay coupons to lower consumers’ out-of-pocket costs for their brand-name prescriptions, though how private health plans treat those coupons can substantially limit their value to consumers. This issue brief provides an ove…

Annual Family Premiums for Employer Coverage Rise 7% to Average $25,572 in 2024, Benchmark Survey Finds, After Also Rising 7% Last Year

Family premiums for employer-sponsored health insurance rose 7% this year to reach an average of $25,572 annually, KFF’s 2024 benchmark Employer Health Survey finds. On average, workers contribute $6,296 annually to the cost of family coverage.   This …

2024 Employer Health Benefits Survey

This annual survey of employers provides a detailed look at trends in employer-sponsored health coverage, including premiums, worker contributions, cost-sharing provisions, offer rates, and more. This year’s report also looks at how employers are addre…

2024 Employer Health Benefits Chart Pack

This slideshow captures key data from the 2024 KFF Employer Health Benefits Survey survey, providing a detailed look at trends in employer-sponsored health coverage, including premiums, employee contributions, cost-sharing, abortion coverage, offer rat…

Medical Debt: The Canary in the Coal Mine for Health Care Affordability

With Vice President Harris promising to address medical debt as part of her economic plan, KFF Executive Vice President for Health Policy Larry Levitt explores why it is a symptom of the broader problem of affordable health care and reviews recent effo…

What are the Consequences of Health Care Debt Among Older Adults?

Health care debt is a widespread problem in the United States. Medicare offers coverage for a range of health care services, including hospitalizations, physician visits, prescription drugs, and post-acute care, but Medicare beneficiaries generally pay…

Five Things to Know About Medicare Site-Neutral Payment Reforms

This brief examines key facts around proposals to align Medicare payments for outpatient services across care settings, otherwise known as “site-neutral payment reforms.”

The Facts About the $35 Insulin Copay Cap in Medicare

This brief describes the facts about actions taken under both the Trump and Biden Administrations related to capping insulin copayments for people with Medicare and explains the differences between their approaches.