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. This means that an uninsured person who develops a certain condition, such as breast cancer, might not be able to buy health insurance. In such an instance, insurance companies can (and often do) refuse to issue a health insurance policy to that individual.

The ACA requires significant changes to guaranteed issue laws. Beginning January 1, 2014, all individual and group health plans must guarantee issue policies to all applicants, regardless of health status or other factors. This fact sheet examines guaranteed issue laws in the individual and small group markets across the nation and how the transition to 2014 will change those markets.

Fact Sheet (.pdf)

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. However, beginning January 1, 2014, insurance companies must meet the Affordable Care Act’s minimum premium rating rules for health plans for individuals and small businesses. This brief explains the current status and trends of rate restrictions and how these trends will change when the ACA is fully implemented.

Fact Sheet (.pdf)

This data snapshot provides the latest data on Children’s Health Insurance Program (CHIP) enrollment and policy trends nationally and across the states through June 2011, based on survey responses and data provided by CHIP directors in all 50 states and the District of Columbia. The report finds that in June 2011, the number of children enrolled in CHIP reached 5.3 million. From June 2010 to June 2011, an additional 178,000 children enrolled in CHIP programs across the country, a rate of growth (3.5 percent) similar to the prior annual period (3.3 percent). While enrollment continues to grow, enrollment growth in the program appears to have moderated since the start of the recession.

Data Snapshot (.pdf)

This nationally representative survey of 500 health insurance agents and brokers working in the individual and small group markets explores their outlook on market trends and views on the Affordable Care Act (ACA). The survey finds that many agents are seeing steep increases in premiums and deductibles for individuals and small businesses purchasing health insurance. When asked to estimate what they expect to be the typical premium increase in 2012 based on what they have heard from insurers, four in ten agents (39 percent) say they expect premiums to increase between 11% and 20% and another third (33 percent) expect them to increase between 6% and 10%. Deductibles are also increasing: about half of agents (51 percent) report that currently, the most common deductible amount for single coverage plans is $2,000 or more, compared to one in five who say deductibles were in this range two years ago.

Report (.pdf)

Toplines (.pdf)

Menlo Park, Calif. and Geneva, Switzerland — The International AIDS Society (IAS), custodian of the International AIDS Conference, and the Kaiser Family Foundation will provide free, worldwide online access to the XIX International AIDS Conference (AIDS 2012) taking place in Washington, D.C., USA.

AIDS 2012 will feature presentations of important new scientific research and opportunities for dialogue on the major challenges facing the global response to AIDS. Kaiser — an independent operating foundation and non-partisan source of facts, information, analysis and journalism, based in Menlo Park, Calif., USA — is the official webcaster for AIDS 2012, providing coverage of daily developments from July 22 to 27 on its website, http://www.kff.org/aids2012/.

In addition to more than 50 online webcasts of conference sessions and press conferences, podcasts will be available for downloading in both English and Spanish. Some sessions, including the Opening and Closing Sessions, will be presented via live webcast, while other coverage will be tape-delayed by a few hours and available on-demand. The webcasts will include sessions featuring President Bill Clinton, South African Health Minister Aaron Motsoaledi, U.S. Secretary of Health and Human Services Kathleen Sebelius, U.S. Global AIDS Coordinator Ambassador Eric Goosby, Bill Gates and Sir Elton John, among others. The full list of webcast sessions (subject to change) is available at http://aids2012.org/.

Kaiser’s Daily Global Health Policy Report, a free, daily news summary service, will be enhanced during the week of the conference to include summaries of what the global media are reporting from the conference and a guide to the latest video session coverage.

Kaiser is also providing the video for conference hubs, which will feature viewings of select AIDS 2012 conference sessions followed by discussions and workshops on how the sessions’ content can be applied locally. The two official conference hubs will be held in Kiev, Ukraine, and Kolkata (Calcutta), India, while more than 40 independent hubs across the world are already planned.

A widget for sharing Kaiser’s content is available for organizations and individuals who want to further spread the information by carrying the coverage on their own websites, blogs or social networking pages. Kaiser’s video content from the conference will also be available to embed on other sites.

“The webcasts are a key part of the IAS’s commitment to ensure that the proceedings at AIDS 2012 have the greatest possible impact in the global response to HIV,” said Elly Katabira, IAS President and International Chair of AIDS 2012. “We are grateful to Kaiser for their partnership with us to take key portions of the conference program directly to locations and communities most deeply impacted by the epidemic.”

“Offering free access to many of the conference sessions allows us to connect people around the world to important HIV/AIDS developments that emerge from this conference,” said Drew Altman, Kaiser President and CEO. “This free, online conference experience ensures key findings and information reach a worldwide audience, including those who might otherwise have no access to the discussions taking place in Washington.”

More information about the conference, including the latest program details, is available at http://aids2012.org/.

Kaiser’s AIDS 2012 conference coverage will be available online through the Foundation’s Global Health Gateway, http://globalhealth.kff.org, which also features Kaiser’s original policy analysis and polling on the U.S. role in global health; country-specific disease and demographic data through the Global Health Facts database; regularly updated resources tracking major policy and budget developments; news summaries from the Kaiser Daily Global Health Policy Report; and a reporter’s guide to covering the global HIV/AIDS epidemic.

About the Kaiser Family FoundationThe Kaiser Family Foundation, a leader in health policy analysis, health journalism and communication, is dedicated to filling the need for trusted, independent information on the major health issues of the day. The Foundation is a non-profit private operating foundation, based in Menlo Park, CA with an office and conference center in Washington, D.C.

About the IAS The International AIDS Society (IAS) is the world’s leading independent association of HIV professionals, with over 16,000 members from more than 196 countries working at all levels of the global response to AIDS. Our members include researchers from all disciplines, clinicians, public health and community practitioners on the frontlines of the epidemic, as well as policy and programme planners. The IAS is the custodian of the biennial International AIDS Conference, which will be held in Washington, D.C., in July 2012, and lead organizer of the IAS Conference on HIV Pathogenesis, Treatment and Prevention.

This fact sheet provides data on oral health care coverage and access for children, nonelderly adults and Medicaid beneficiaries, including state-by-state data on measures such as the share of adults who have had a dental visit within the past year.

Fact Sheet (.pdf)

This report is based on a focus group discussion in May 2012 with the Executive Board of the National Association of Medicaid Directors (NAMD) and other leading Medicaid directors. The group of nine directors reflected perspectives from various regions of the country. The discussion focused on state fiscal conditions, Medicaid spending and enrollment trends, key Medicaid policy changes and federal health care reform implementation. At the time of the meeting, most states were wrapping up FY 2012 and preparing for FY 2013.

Report (.pdf)

A Mid-Year State Medicaid Budget Update for FY 2012 & A Look Forward to FY 2013

Moving Ahead Amid Fiscal Challenges: A Look at Medicaid Spending, Coverage and Policy Trends Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2011 and 2012

As state and federal policymakers move to develop and test integrated care models for people dually eligible for Medicare and Medicaid, two new Kaiser Family Foundation articles in the June 2012 issue of Health Affairs highlight the diverse needs and challenges facing these 9 million beneficiaries, describe their current care arrangements, and raise issues to consider for proposed reforms aimed at better coordinating their care and reducing health care spending.

The first highlights the diversity of the dual-eligible population, which includes low-income elderly beneficiaries and younger people with disabilities, those using long-term services and supports, and many others living with a wide range of health conditions and disabilities. The commentary suggests targeting care models and payment reforms to meet the needs of specific groups of beneficiaries, expanding programs slowly over time to allow managed-care plans to build their provider networks, and not counting cost savings before they materialize. Dx For A Careful Approach To Moving Dual-Eligible Beneficiaries Into Managed Care Plans is authored by the Foundation’s Tricia Neuman, Barbara Lyons, Jennifer Rentas and Diane Rowland.

Commentary

The second examines data on current care arrangements for dual-eligible beneficiaries, assesses the extent to which dually eligible beneficiaries are enrolled in managed or coordinated Medicare or Medicaid plans, and examines companies’ experience in providing care for this population in Medicare or Medicaid managed care plans. The study finds that most dually eligible beneficiaries receive Medicare and Medicaid services through unmanaged, uncoordinated care arrangements. However, many managed care companies provide both Medicaid and Medicare benefits to this population in non-integrated ways. The study also found wide variation across states, and gaps in the data about dually eligible beneficiaries’ experiences with coordinated care plans. There is Little Experience and Limited Data to Support Policy Making on Integrated Care for Dual Eligibles is authored by Marsha Gold of Mathematica Policy Inc. and the Foundation’s Gretchen Jacobson and Rachel Garfield.

Article

This policy brief provides data and analysis of coverage and access to oral health care for low-income nonelderly adults. Lack of resources to pay for dental services, either through dental insurance or out-of-pocket, is a major barrier to oral health care for many low-income Americans. The problem is particularly acute for low-income adults, who are more likely to be uninsured than low-income children.

Issue Brief (.pdf)

This policy brief highlights the prevalence of dental problems among children and examines gaps in oral health coverage and access to dental care, as well as disparities by income and race/ethnicity. It also looks at out-of-pocket costs for dental care, explains the role of Medicaid and CHIP in dental care, coverage and access for children and describes the expansion of oral health coverage for children under the Affordable Care Act.

Issue Brief (.pdf)