Study shows Medicare primary care visits shifting from physician offices to hospital-affiliated and multispecialty practices, influenced by ACA funding and Medicare reimbursement policies.

Medicare beneficiaries face higher costs as Part D plans shift from fixed co-pays to coinsurance for expensive Tier 3 drugs, raising out-of-pocket expenses significantly.

Analysis shows reducing federal match for Medicaid expansion may cause 34,200 more deaths annually if states cut coverage. Legislative action by Republicans under review.