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This brief reviews medical underwriting practices by private insurers in the individual health insurance market prior to 2014, and estimates how many American adults could face difficulty obtaining private individual market insurance because of a pre-existing condition if the Affordable Care Act (also known as Obamacare) were repealed or amended and such practices resumed.
This slideshow highlights changes in insurer participation in the Affordable Care Act marketplaces for 2017, including a county-by-county map.
To gauge whether individual market risk pools are healthier in states that have expanded Medicaid and did not allow transitional plans, this data note compares average state risk scores using data from the Centers for Medicare & Medicaid Services Summary Report on Risk Adjustment for the 2015 benefit year. The analysis finds that states that expanded Medicaid and did not allow transitional plans had lower average risk scores, suggesting the risk pools in those state’s…
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.
Premium increases in the health insurance marketplaces created under the Affordable Care Act (ACA) will likely be higher in 2017 than in recent years; however, the actual average benchmark premium in the ACA marketplaces in 2016 is below what the Congressional Budget Office projected for 2016 before the health law was passed. How actual marketplace premiums compare to what CBO expected in doing those budget projections is an important factor in determining whether the ACA…
In its third year, the survey tracks the experiences of assistance programs signing people up for Affordable Care Act coverage during open enrollment and, for consumers who qualify, during special enrollment periods. This year, for the second time, the survey includes health insurance brokers who helped people apply for non-group coverage in an ACA marketplace.
This brief explores the problem of "surprise medical bills" -- charges arising when an insured individual inadvertently receives care from an out-of-network provider. It reviews studies on the extent of the issue, including Kaiser Family Foundation polling data, and outlines state and federal policy responses, including rules and proposed rules for Medicare and plans in Affordable Care Act marketplaces.
This analysis examines factors that may have kept 2016 enrollment in Affordable Care Act (ACA) marketplace plans from reaching early projections, and it estimates that sign-ups will continue to grow modestly in coming years.
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