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Changing Rules for Workplace Wellness Programs: Implications for Sensitive Health Conditions

With legislation pending in Congress that would substantially change federal rules governing workplace wellness programs, this brief reviews relevant data about employers’ use of wellness programs and financial incentives and the incidence of certain sensitive or potentially stigmatized health conditions among adults covered under employer-sponsored health plans.

New Analysis Examines Proposed Changes to Workplace Wellness Programs

As Congress considers legislation that would change federal rules governing workplace wellness programs that gather information about workers’ health and risk status, a new Kaiser Family Foundation brief explains how workplace wellness programs could be affected and possible implications for workers with sensitive health conditions. Among the findings: Seven in…

Explaining Health Care Reform: Risk Adjustment, Reinsurance, and Risk Corridors

This brief explains three provisions of the Affordable Care Act (ACA) – risk adjustment, reinsurance, and risk corridors – that were intended to promote insurer competition on the basis of quality and value and promote insurance market stability, particularly in the early years of reform as the ACA marketplaces, also known as exchanges, were established.

How Will the Uninsured in West Virginia Fare Under the Affordable Care Act?

This state report explains how the ACA expands coverage in West Virginia, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in West Virginia are eligible for Medicaid or financial assistance in the Marketplace. For states not expanding Medicaid, the report quantifies how many uninsured people fall into the “coverage gap,” meaning they will be ineligible for financial assistance in the Marketplace or for Medicaid in their state despite having an income below the federal poverty level.

Issues for Structuring Interim High-Risk Pools

One of the first provisions that would be implemented under federal health reform bills in the House and the Senate would establish a national high-risk pool program to offer coverage to otherwise uninsurable individuals during the interim period between enactment and implementation of broader health care reforms. High-risk pools provide…

Statement of Gary Claxton to NAIC Exchanges (B) Subgroup

Kaiser Family Foundation Vice President Gary Claxton, who directs the Foundation’s Marketplace Policy Project, testified July 22, 2010, at a public hearing before the National Association of Insurance Commissioners’ Exchanges (B) Subgroup established by the health reform law.  Testimony (.pdf)

Mapping Premium Variation in the Individual Market

This analysis examines how premiums for individual health insurance differ around the nation, finding that premiums can vary substantially from state to state. The average per-person premium in 2010 ranged in cost from approximately $136 per month in Alabama to more than $400 per month in Vermont and Massachusetts. The…

Insurer Rebates under the Medical Loss Ratio: 2012 Estimates

Beginning in 2011, the Affordable Care Act (ACA) requires insurance plans to pay out a minimum percentage of premium dollars towards health care expenses and quality improvement activities, limiting the amount spent on administrative and marketing costs and profit. Under the law, large group plans are required to spend at…

Quick Take: Timing Matters: States Waiting for a Supreme Court Decision to Plan an Exchange

State-based health insurance exchanges are an important component of the Patient Protection and Affordable Care Act (ACA) designed to extend subsidized private health insurance coverage to millions of Americans by 2014. Though projections show exchange enrollment could grow to 20 million individuals nationally, aggressive planning on the part of states…

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.