Medicare: Families USA Publications
Buyer Beware: Higher Costs, More Confusion for the 2008 Part D Enrollment Season discusses several reasons why Part D enrollees, especially those with low incomes, should carefully examine their plans to see if the plans will continue to suit their needs. These reasons include rising premiums, the widening "doughnut hole," and other changes in coverage. 4 pp. Free (November 2007)
The CHAMP Act's Medicare Provisions Offer Real Help to Seniors and People with Disabilities discusses how this bill, passed by the House of Representatives on August 1, would level the playing field between traditional Medicare and private Medicare Advantage plans, improve benefits for beneficiaries, particularly for those with low incomes, and protect Medicare consumers. 4 pp. Free (September 2007)
Whose Advantage? Billions in Windfall Payments Go to Private Medicare Plans Medicare's private plans, now called Medicare Advantage plans, were supposed to save taxpayers money and provide better health care for beneficiaries. In reality, they are paid billions more than traditional Medicare while providing little, if anything, in the way of improved care. 12 pp. Free (June 2007)
Medicare Part D Drug Prices Are Climbing Quickly explains that private insurance plans have not been able to negotiate lower drug prices in the Medicare Part D drug program, creating a growing burden for seniors and taxpayers. 4 pp. Free (April 2007)
Rhetoric versus Reality: Comparing Medicare Part D Prices to VA Prices rebuts the main arguments against comparing drug prices under Medicare Part D and those obtained by the Department of Veterans Affairs. 4 pp. Free (April 2007)
Medicare's Phony Problem: The 45 Percent Threshold examines the fundamental flaws inherent in the 45 percent threshold and discusses why correcting this nonexistent problem could do serious harm to beneficiaries and to Medicare itself. 5 pp. Free (March 2007)
No Bargain: Medicare Drug Plans Deliver High Prices presents an analysis of drug prices that Part D plans charge for the 20 drugs most frequently prescribed to seniors for each of the plans offered by the five largest Part D insurers compared to the prices secured by the VA. We found that VA prices are substantially lower than the lowest prices charged by the largest Part D insurers for all of these 20 drugs. We also found that the seven largest U.S. pharmaceutical companies spent more than twice as much on marketing, advertising, and administration as they did on R&D. 23 pp. $15.00 (January 2007)
Stop Bad Ideas—Private Gain and Public Pain in Medicare discusses how the push to privatize Medicare has resulted in landmark profits for the drug and insurance industries at the expense of taxpayers and Medicare beneficiaries. 4 pp. Free (December 2006)
Picking a Part D Plan: Déjà Vu All Over Again? discusses why beneficiaries, advocates, and health care providers should be aware of changes in Part D plans that will affect coverage in 2007. It also urges all beneficiaries to examine premiums, drug costs, formularies, and drug restrictions to find the best Medicare drug plan. 4 pp. Free (November 2006)
Coverage through the "Doughnut Hole" Grows Scarcer in 2007 examines what will happen next year to stand-alone drug plans that provide meaningful doughnut hole coverage—plans that provide doughnut hole coverage of both the generic and non-generic drugs that most seniors need. 12 pp. Free (November 2006)
Medicare Privatization: Windfall for the Special Interests examines how several decisions by Congress to promote privatized Medicare are costing taxpayers billions of dollars and bringing windfall profits to the insurance and drug industries. The report focuses on 1) overpayments to Medicare Advantage plans, 2) special funding for Medicare regional PPOs, and 3) prices obtained by Part D drug plans. 16 pp. Free (October 2006)
Big Dollars, Little Sense: Rising Medicare Prescription Drug Prices asks two key questions: 1) What has happened to Part D prices for the most frequently prescribed drugs from November 2005 to April 2006?; and 2) How do Part D drug prices now compare to the prices secured by the VA? The answers are both clear and disappointing: 1) Virtually all of the Part D plans raised their prices for the majority of the top 20 drugs in this study. 2) For all of the top 20 drugs prescribed to seniors, VA prices in April were lower than the lowest prices charged by Part D plans. 25 pp. $15.00 (June 2006)
April Fools for Medicare Part D Beneficiaries? Transitional Benefits End April 1 On April 1, 2006, Medicare beneficiaries lose the protection of extended transition benefits. This memo explains what this means for beneficiaries and what they can do about it. (March 29, 2006)
President Bush's Fiscal Year 2007 Budget: Analysis of Key Health Care Provisions Includes discussion and commentary on Health Savings Accounts (HSAs), Medicaid, and Medicare. 13pp. (February 22, 2006)
Expectations Shrinking for Medicare Part D Enrollment assesses the first two months of enrollment in the new drug benefit. The report shows that: 1) enrollment so far is lagging well behind last year's projections; 2) most of those counted as covered already had drug coverage; and 3) low-income beneficiaries are being left behind. 6 pp. Free (February 2006)
Falling Short: Medicare Prescription Drug Plans Offer Meager Savings evaluates how well Medicare prescription drug plans (PDPs) did in giving seniors low drug prices. This report compares the base drug prices reported by Medicare drug plans with the prices negotiated through the Department of Veterans Affairs (VA). 19 pp. Free (December 2005)
Getting the Best Price: Lessons Learned from the Medicare Discount Card Program Families USA examined how well the Medicare discount card program did in negotiating lower drug prices for those in Medicare. We found that, for the 50 drugs most frequently prescribed to seniors, the lowest Medicare discount card price was almost always much higher than the lowest price negotiated by one large government purchaser, the Department of Veterans Affairs (VA). 27 pp. $15.00 (September 2005)
Gearing Up Series--The Holes in Part D: Gaps in the New Medicare Drug Benefit (Part 1 of 2) This brief discusses the three major kinds of gaps associated with the Part D benefit: 1) the financial gap beneficiaries will face; 2) the drug coverage gap; and 3) the enrollment gap. 15 pp. Free (July 2005)
Gearing Up Series--Filling the Holes in Part D: The Essential Role of State Pharmacy Assistance Programs (Part 2 of 2) This brief examines the key decisions states will have to make when determining how their Pharmacy Assistance Programs can provide wraparound coverage and explains the special role of these programs under the Medicare drug law. It also discusses how these programs can help with enrollment. (July 2005)
Health Issues 2004: A forum to discuss America's health care crisis, chaired by Senator Edward Kennedy
Gearing Up: States Face the New Medicare Law Is Your State Ready for 2006? An Introduction to What the New Medicare Part D Prescription Drug Benefit Means for Medicaid -- The new Medicare law will require big changes in state Medicaid and prescription drug assistance programs. This piece describes the new Medicare drug benefit and outlines some of the major issues state policy makers and advocates need to consider as they plan to implement the new law. 15 pp. Free (September 2004)
Sticker Shock: Rising Prescription Drug Prices for Seniors
This updated study examines price changes for the top 30 brand-name drugs prescribed for seniors. The survey found that the prices of these drugs have increased by nearly 22 percent over the past three years. 21 pp. $15.00 (June 2004)
The new Medicare prescription drug legislation creates a temporary drug discount card program that is projected to start in June 2004 and end by January 1, 2006, when a new, permanent drug benefit would begin. The New Medicare Prescription Drug Discount Card: A Very Flawed Program discusses the flaws in the program and how they are likely to affect Medicare beneficiaries. (December 19, 2003)
The Immigrant Children's Health Improvement Act (ICHIA): A Good Investment in America's Future | en Español (December 11, 2003)
FEHBP Rates Increase as Much as $4,572.12 a Year: Is This Really A Model for Medicare? examines whether the Federal Employee Health Benefits Program (FEHBP), a model used by the House Medicare prescription drug bill, is a good model for the seniors and people with disabilities that Medicare serves. 4 pp. Free (September 30, 2003)
The House Medicare Drug Bill's Doughnut Hole: A Chasm for Low-Income Beneficiaries discusses the large gap in drug coverage low-income Medicare beneficiaries would experience under the House Medicare drug bill. 2 pp. Free (September 26, 2003)
Private Plans: A Bad Choice for Medicare
This Health Policy Memo discusses the role of private plans in Medicare up to this point. According to the piece, the evidence so far indicates that, for seniors and people with disabilities, particularly those living in rural areas, the traditional Medicare program works better than private plans. 2 pp. Free (September 26, 2003)
Prescription Drug Cost-Sharing and Low-Income People: Five Good Reasons to Keep It Minimal makes the point that prescription drugs aren't the only health expenses Medicare beneficiaries must pay for out of pocket. It goes on to assert that any final Medicare prescription drug bill should not raise cost-sharing amounts above the limits in the current Senate and House bills. (September 12, 2003)
More Red Tape for the Poor? Dual Eligibles in the Medicare Rx Bill describes the potential problems that the Senate's Medicare prescription drug bill, which would not cover dual eligibles (low-income people who are eligible for both Medicare and Medicaid), could create for such beneficiaries and for Medicare and state Medicaid programs.(September 3, 2003)
What's in the House and Senate Medicare Prescription Drug Bills? provides a side-by-side comparison of the two bills, examining basic drug benefits, premiums, out-of-pocket spending, and gaps in coverage for Medicare beneficiaries. 4 pp. (July 17, 2003)
A large percent of those enrolled in Medicare are considered low-income. Who Are Medicare's Low-Income Beneficiaries? examines the group’s demographics and their ability to obtain affordable health services. (July 14, 2003)
Out of Bounds: Rising Prescription Drug Prices for Seniors documents the price increases for the top 50 prescription drugs sold to seniors. The report examines the price increases that occurred from January 2002 to January 2003 for each of these 50 drugs. On average, those prices rose almost three-and-one-half times the rate of inflation. 23 pp. $15.00 (July 2003)
Low-Income Medicare Beneficiaries Are Most in Need of Prescription Drug Coverage 2 pp. Free (June 17, 2003)
Top Dollar: CEO Compensation in Medicare's Private Insurance Plans documents the lavish salaries and compensation offered to the top executives in the leading health care plans currently serving Medicare enrollees. The report compares the annual compensation packages for the highest-paid executives in 11 publicly traded, private health insurance companies. 35pp. $15 (June 2003)
Managed Care Plans Offer No Real Choice for Rural Medicare Beneficiaries (May 2003)
Issue Brief: WHY FEHBP Isn't a Good Option For Medicare - The Federal Employees Health Benefit Program (FEHBP) has frequently been pointed to as a model for Medicare. An FEHBP-style overhaul is favored by many, but before it is seen as a panacea for Medicare, it is worth considering how well its basic structure fits Medicare--a fit that is not the best. 9 pp. Free. (March 2003)
The Bush Administration's Fiscal Year 2004 Budget: Analysis of Key Health Care Provisions
4 pp. Free. (February 7, 2003)
Bitter Pill: The Rising Prices of Prescription Drugs for Older Americans
Prices for the top 50 drugs used by senior citizens continue to outstrip inflation. From 2001 to 2002, prices for these drugs grew by 7.8 percent: Name-brand drugs increased by 8.1 percent, while lower-priced generics grew by only 1.8 percent. 18 pp. $15.00. (June 2002)
Failing America's Seniors: Private Health Plans Provide Inadequate Rx Drug Coverage. A Special Report. 8 pp. Free. (May 2002)
Assessing the Bush Administration's Proposed Medicare Drug Discount Card Program.
A Special Report. 4 pp. Free. (March 2002)
President Bush's Medicare Drug Proposals introduces the President’s plans to create a prescription drug discount card program, encourage states to seek federal Medicaid waivers, and establish the Medicare Low-Income Drug Assistance Program. (February 13, 2002)
Consumer Health Assistance Programs: Report on a National Survey
Consumer health assistance programs come in many shapes and sizes. Some serve Medicare beneficiaries, for example; some serve people in long-term care facilities or those who are privately insured. Families USA conducted a nationwide survey of these programs, and the findings are summarized in this report. 48 pp. $15.00 (July 2001)
Designing a Consumer Health Assistance Program
As health care becomes more complex, many states and localities are developing consumer health assistance programs to meet the needs of consumers within their jurisdictions. This guide reviews some key considerations to keep in mind when designing such programs. 24 pp. $15.00. (June 2001)
Enough to Make You Sick: Prescription Drug Prices for the Elderly
For the millions of older Americans who do not have prescription drug coverage, and for millions of others who have very limited coverage, increases in drug prices have a profound impact. As this report demonstrates, these prices are increasing at rates that far exceed inflation. 17 pp. $15.00. (June 2001)
Bush Budget Speeds Medicare Insolvency by 15 Years. A Special Report. 4 pp. $2.00. (March 2001)
Cost Overdose: Growth in Drug Spending for the Elderly, 1992-2010
America's seniors face prescription drug costs that are projected to more than double in the next 10 years. This report tracks the rise in drug spending from 1992 through 2000 and projects increases through 2010. 24 pp. $15.00 (July 2000)
Still Rising: Drug Price Increases for Seniors 1999-2000
America's senior citizens are falling farther and farther behind in their struggles to pay for prescription drugs as the prices for those drugs increase faster than inflation. This update of Hard to Swallow looks at the rising costs of the 50 drugs most commonly prescribed for senior citizens. 13 pp. $5.00. (April 2000)
"Key Features of President Clinton's Medicare Reform Bill"
2 pp. Free. Print only. (March 2000)
"The Breaux-Frist Bill: Look Before You Leap,"
The Future of Medicare: #1. 2 pp. Free. Print only. (March 2000)
"Turbulence Ahead for Seniors Under the Breaux-Frist Plan,"
The Future of Medicare: #2. 2 pp. Free. Print only. (March 2000)
"The Breaux-Frist Proposal Will Jeopardize the Traditional Medicare Program,"
The Future of Medicare: #3. 2 pp. Free. Print only. (March 2000)
"The Federal Employees Health Benefits Plan Not a Model for Medicare,"
The Future of Medicare: #4. 2 pp. Free. Print only. (March 2000)
"The Breaux-Frist Bill Puts Rural Residents at Risk,"
The Future of Medicare: #5. 2 pp. Free. Print only. (March 2000)
"Medicare Beneficiaries Need Drug Coverage Breaux-Frist Proposal Fails the Test,"
The Future of Medicare: #6. 2 pp. Free. Print only. (March 2000)
Hard To Swallow: Rising Drug Prices for America's Seniors A look at the skyrocketing costs of the 50 drugs most used by older Americans. Every year for the last five years, the prices of these drugs have increased faster than the rate of inflation, with increases in 1998, on average, four times the rate of inflation. 16 pp. $15.00. (November 1999)
Rural Neglect: Medicare HMOs Ignore Rural Communities
A look at the availability of Medicare HMOs in non-metropolitan counties in the U.S., which finds that 73 percent of rural Medicare beneficiaries have no access to any Medicare HMO. Concludes that Medicare reform should not be predicated on HMOs. 19 pp. $15.00. (September 1999)
The Impact of Medicare Reform on Low-Income Beneficiaries
An 11-page report on what should be done to make sure low-income Medicare beneficiaries are helped, not hurt, by Medicare reform. $5.00. (March 1999)
Shortchanged: Billions Withheld from Medicare Beneficiaries
Four million low-income Medicare beneficiaries are entitled to, but not receiving, subsidies to help cover their Medicare premiums and, for some, their deductibles and co-payments. This 29-page report provides the state-by-state numbers of low-income elderly or disabled persons who should be receiving QMB, SLMB, or QI-1 benefits and the dollar amounts they have lost, with recommendations for government action. 29 pp. $15.00. (July 1998)
Monitoring Medicare HMOs: A Guide to Collecting and Interpreting Available Data
Aimed at groups working with Medicare beneficiaries, this 86-page guide provides step-by-step instructions for gathering and making sense of Medicare HMO data from federal agencies, state governments, and other sources. Parts of the guide will be useful to those interested in Medicaid and/or commercial HMOs. 86 pp. $15.00. (May 1998)
Comparing Medicare HMOs: Do They Keep Their Members?
This 44-page report looks at Medicare HMOs to see how many beneficiaries quit, or disenroll. Includes state-by-state and plan-by-plan data on the overall disenrollment rates as well as "rapid" disenrollment rates. The report finds that the lowest disenrollment rates, indicating that beneficiaries are generally satisfied, are in nonprofit plans with a long history of serving Medicare beneficiaries. $15.00. (December 1997)
The Crushing Costs of Medicare Supplemental Policies.
A Special Report This special report presents findings of a Families USA study of dramatic increases in the premiums charged for Medigap insurance. 31 pp. Free. Print only. (October 1996)
Medicare Beneficiaries With Low and Modest Incomes Hurt by Proposed Cuts. A Special Report
8 pp. Free. Print only. (September 1995)
Low-Income Medicare Beneficiaries Need Federal Protection. A Special Report
4 pp. Free. Print only. (August 1995)
Worthless Promises: Drug Companies Keep Boosting Prices
A look at price increases in the 20 top selling brand name prescription drugs used by all Americans, and in 20 top selling drugs used by older Americans from 1989 to 1994. Compares median profits of pharmaceutical manufacturers to those of Fortune 500 companies. 19 pp. $5.00. Print only. (March 1995)
The Medicare Buy-in: A Promise Unfulfilled
A description of the Medicare buy-in benefits, the Qualified Medicare Beneficiary (QMB) and Specified Low-income Medicare Beneficiary (SLMB), and the failure of federal and state governments to provide Medicare buy-in benefits to almost half of those eligible; contains state-by-state estimates. 26 pp. $5.00. Print only. (March 1993)
Crossing to Mexico: Priced Out of American Health Care
A survey of Mexican doctors and American consumers about the reasons Americans go to Mexico for routine medical care. Includes price comparisons and physician visits. 20 pp. $5.00. Print only. (November 1992)
Making Them Wait for Social Security Benefits
16 pp. $5.00. Print only. (October 1992)
The Health Cost Squeeze on Older Americans
23 pp. $5.00. Print only. (February 1992)
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