Medical Article

More than two in five (42%) or 57.4 million adults under 65 with private insurance could be eligible under clinical criteria for GLP-1 drugs used to treat people with type 2 diabetes, obesity, or excess weight and weight-related health issues, according to a new KFF analysis. Though only about 3% of adults with employer coverage…More

KFF is the independent source for health policy research, polling, and journalism. Our mission is to serve as a nonpartisan source of information for policymakers, the media, the health policy community, and the public.

This brief examines the two presidential candidates’ records and other recent policy proposals that could inform starkly different directions for the program across key areas, including Affordable Care Act (ACA) Medicaid expansion, financing, eligibility, benefits, and cost-sharing, prescription drugs, long-term services and supports, and managed care.

Section 1115 Medicaid demonstration waivers offer states an avenue to test new approaches in Medicaid that differ from what is required by federal statute, so long as the approach is likely to “promote the objectives of the Medicaid program.” As with broader Medicaid policy, the future landscape of Section 1115 waivers depends on the outcome…

Millions of healthcare claims are denied annually, costing providers billions in lost revenue and expensive appeals. A 2024 survey shows that around 15% of all claims submitted to private payers, Medicare Advantage and Medicaid managed care plans are initially denied. Since most involve charges of $14,000 and above, the stakes are worryingly high. Frustratingly, more…