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Insurers pursue multiple strategies to reduce the cost of covering enrollees with pre-existing conditions, or medical conditions and health problems that existed before the individual enrolled in a health plan.
This report from the Kaiser Family Foundation analyzes the effect of government efforts to ensure that insurance premium increases are justifiable and provide value to consumers and small businesses.
This analysis of the House Budget Plan that was passed in 2012 finds that repealing the Affordable Care Act (ACA) and converting Medicaid to a block grant would trigger significant decreases in federal Medicaid spending and could result in substantial reductions in enrollment and payments to providers compared to current projections.
This fall a new rule takes effect requiring all private health plans to offer a uniform, simple to read, summary of benefits and coverage (SBC). The SBC will provide consumers with standardized information about how plans cover essential health benefits and what coverage limits and cost sharing applies.
Medicaid covers more than 60 million Americans and accounts for about one in six dollars spent on health care in the United States.
Rate restrictions limit how much insurance companies can vary premiums charged to individuals and businesses based on factors such as health status, age, tobacco use and gender. Currently, federal law does not place any limits on the ways that insurance companies set their premium rates.
Guaranteed issue laws require insurance companies to issue a health plan to any applicant - an individual or a group - regardless of the applicant's health status or other factors. Currently, in most states, insurance companies can deny nongroup coverage to people based on their health status or their medical expenses over the past year.
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.
This background brief provides a comprehensive look at the appeals process for the Medicaid program, which differs significantly from those available through the Medicare program and private health insurance.
¿Esta confundido acerca de cómo la nueva ley de reforma de salud realmente funciona? Este video explica los problemas relacionados con el sistema de salud actual, los cambios que están sucediendo ahora, y los cambios importantes que se anticipan para el 2014.
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