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  • The Cost of the Individual Mandate Penalty for the Remaining Uninsured

    Issue Brief

    This analysis provides estimates of the share of uninsured people eligible to enroll in the Affordable Care Act marketplaces who will be subject to the individual mandate penalty, and how those penalties are increasing for 2016. It also provides estimates of the number of people who could have a zero-dollar contribution or pay less for health insurance than the penalty, due to premium subsidies, and the number of people who would pay more for a…

  • Medicare Advantage 2016 Data Spotlight: Overview of Plan Changes

    Issue Brief

    This issue brief analyzes the number and variety of Medicare Advantage plan choices available to beneficiaries in 2016. It describes trends in number of Medicare Advantage plans, plan premiums, and plan quality ratings, including changes in prescription drug coverage and limits on out-of-pocket expenses. This spotlight is part of a series of spotlights tracking key changes in the Medicare Advantage program.

  • Health Center Patient Trends, Enrollment Activities, and Service Capacity: Recent Experience in Medicaid Expansion and Non-Expansion States

    Issue Brief

    In thousands of medically underserved communities across the U.S., community health centers enroll low-income people in health coverage and provide care to millions of patients. Against the backdrop of significant health center expansion over several years and a full year of expanded health coverage under the Affordable Care Act (ACA), this brief examines change between 2013 and 2014 in the volume and health coverage profile of health center patients, and health center enrollment activities and…

  • It Pays to Shop: Variation in Out-of-Pocket Costs for Medicare Part D Enrollees in 2016

    Issue Brief

    This analysis focuses on out-of-pocket drug costs for Medicare Part D enrollees in 2016 for specialty, brand, and generic drugs. Part D drug plans differ considerably in the drugs they list on their formularies, their use of formulary tiers, and the level and structure of cost sharing applied to those tiers. Plan decisions affect different beneficiaries in different ways, depending on the drugs they use. The financial consequences for Part D plan enrollees can be…

  • Data Note: Are Nonprofits Requesting an Accommodation for Contraceptive Coverage?

    Issue Brief

    The Affordable Care Act (ACA) requires most private health insurance plans to provide coverage for a broad range of preventive services, including most contraceptives for women. This policy was at the center of a Supreme Court case brought forward by for-profit corporations (Hobby Lobby and Conestoga) that successfully claimed that the contraceptive coverage requirement violated their religious rights. Last month, the Supreme Court agreed to hear yet another challenge (Zubik v Burwell) to the contraceptive…

  • Potential Savings from Actively Shopping for Marketplace Coverage in 2016

    Issue Brief

    This analysis looks at how the premiums for the lowest-cost silver plans in Affordable Care Act (ACA) Marketplaces changed between 2015 and 2016. The analysis examines premiums of the 2015 lowest-cost silver plans (in states that used Healthcare.gov in both 2015 and 2016) for a single 40 year-old adult to see how much these premiums increase in 2016 and whether enrollees could obtain lower premiums by switching plans.

  • Patient Cost-Sharing in Marketplace Plans, 2016

    Issue Brief

    This brief and accompanying slides examine cost sharing - deductibles, copayments and coinsurance - in 2016 insurance plans sold on the Affordable Care Act's (ACA) federally-facilitated marketplaces. The analysis looks at out-of-pocket limits, as well as cost sharing for hospital stays, physician visits, emergency room visits, and prescription drugs, for plans across the metal levels (platinum, gold, silver and bronze).