This week, the Kaiser Family Foundation (KFF) released an issue brief analyzing the availability of, and enrollment in Medigaps across different states. One in four people in traditional Medicare had this private, supplemental health insurance in 2015. Medigaps help cover Medicare deductibles and cost-sharing, reduce the out-of-pocket burden associated with accessing care, and protect against high costs because of catastrophic illness or injury.

This week, the Kaiser Family Foundation released a new issue brief on Medicare spending. The brief analyzes the most recent historical and projected Medicare spending data published in the 2018 annual report of the Boards of Medicare Trustees and the 2018 Medicare baseline and projections from the Congressional Budget Office (CBO).

In 2017, Medicare spending accounted for 15% of the federal budget, and for 20% of total national health spending in 2016. It also accounted for 29% of spending on retail sales of prescription drugs, 25% of spending on hospital care, and 23% of spending on physician services.

Last week, the Medicare Rights Center explained how the House majority’s budget plan for 2019 would fundamentally restructure Medicare and Medicaid, slashing more than $2.1 trillion from the programs over 10 years. Though this approach is not unexpected—as lawmakers promised to use deficits created by last year’s tax bill as an excuse to pursue such cuts—it is extremely troubling.

This week, the Health Policy Consensus Group—a consortium of think tanks and former and current lawmakers—put forward a new plan to repeal the Affordable Care Act (ACA) that would end Medicaid expansion and eliminate the ACA’s robust consumer protections for individuals with preexisting conditions, adults over 50, and women. If this sounds familiar, it should. Last year saw several plans to end the ACA’s Medicaid funding and consumer protections, often couched in language promising states more “flexibility.” These proposals would have caused millions of Americans to lose access to critical services, pay more for care, or even lose health coverage entirely.

This week, House Republicans unveiled a 2019 budget proposal that would balance the federal budget in nine years—largely by significantly cutting and fundamentally restructuring Medicare and Medicaid. This approach is not unexpected. Lawmakers were clear that after passing a costly tax bill that drives up deficits, they would use these higher deficits to justify cuts to programs like Medicare. In the House budget resolution, they are keeping that promise: the budget would end Medicare and Medicaid as we know them.

In its annual report to Congress, the Board of Trustees for Medicare said the program’s hospital insurance trust fund (Part A) could lack funds to pay full benefits by 2026—three years earlier than projected in last year’s report. Despite this finding, the Medicare program itself remains strong and sustainable. The trustees report identifies several factors that impact the balance of program funds.

Last week, the Department of Justice (DOJ) asked a federal court in Texas to end the Affordable Care Act’s (ACA) protections for people with pre-existing conditions. The underlying legal challenge was filed earlier this year by 20 state attorneys general, who argue that without the individual mandate—which was eliminated in December’s Tax Cuts and Jobs Act—the entire is ACA unconstitutional. In an unexpected move, the DOJ declined to defend the ACA in this case, and instead asked the court to invalidate only the law’s provisions that prevent insurers from denying coverage or charging higher rates based on health status.

This week, the Centers for Medicare & Medicaid Services (CMS) expanded the time-limited equitable relief opportunity to people who are enrolled in Marketplace plans but could have enrolled in Medicare Part B during their Special Enrollment Period (SEP), which was available to them after they lost their or a spouse’s job-based insurance.

Last week, the Medicare Rights Center submitted comments to the Center for Medicare & Medicaid Innovation (CMMI) in response to a request for information on a potential new Medicare model. CMMI—an offshoot of the Centers for Medicare & Medicaid Services (CMS), which is the agency that oversees the Medicare program—was created to develop and test new ideas in health care delivery. Most of these ideas involve different ways of paying providers such as doctors or hospitals.

In this request for information, CMMI asked interested parties to provide input on ways to design and test a model for Direct Provider Contracting (DPC). In a DPC model, a beneficiary could choose to join a primary care or specialty provider’s practice and potentially gain certain benefits such as reduced cost sharing or increased services that Medicare does not generally pay for. While this idea may be intriguing, CMMI did not provide any detail on how such a model would work, which leaves some dangerous options on the table.

This week, Avalere Health, a Washington DC-based consulting firm that specializes in strategy, policy, and data analysis, released a study on the impact of moving the coverage of some drugs from Medicare Part B to Part D. While most drugs are covered under the Part D prescription drug program, Part B, the part of the Medicare program that covers outpatient medical services like office visits, covers a few. The drugs covered by Part B are usually ones that beneficiaries would not give to themselves. For example, if a provider administers the drug during an office visit, Part B instead of Part D, might cover that drug.

Earlier this month, the Trump Administration announced it would consider transitioning certain Part B drugs into Part D as part of a larger strategy to lower drug prices and out-of-pocket costs. This makes it essential to understand what effects the switch could have on people with Medicare.