Policy Insights

This policy insight examines the low rate of Medigap coverage among people under age 65 with disabilities on Medicare and the federal law that governs consumer rights and protections related to Medigap open enrollment.

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 continues to be on track to reducing the deficit.

This brief discusses the key factors that will influence the rate changes that insurers are requesting in 2017 Affordable Care Act (ACA) Marketplaces, including current premiums, forecasted enrollment changes, increases in price and use of services, changes in policy design or network, changes in law or regulation, and competition.

In the latest post in the Policy Insights series, Jen Kates, Josh Michaud, and Allison Valentine examine how rapid emergence of Zika virus in the Americas, and its association with a severe birth defect, impact women as some health officials are calling for women to avoid pregnancy even though they have limited reproductive health access in some of the affected countries. They also examine the role of the U.S. government in addressing Zika and its impact on women in Latin America and the Caribbean.

In this new policy insight, Tricia Neuman examines current rules that may discourage seniors from switching from Medicare Advantage to traditional Medicare. The issue is explored through the lens of a 67-year-old beneficiary who faced difficult financial and health coverage choices in the aftermath of a serious biking accident.

In this Policy Insight, Jen Kates and Josh Michaud look at the prospects for the future of U.S. global health policy, examining whether long-term bipartisan support may be tested during a time of political transition, and identifying key areas of consensus among policymakers and the public.

This analysis tracks the financial performance of insurers in the individual market by evaluating trends in the medical loss ratio (MLR) in the pre-ACA landscape from 2010 to 2013 and estimates the MLR for the first full year of Affordable Care Act implementation in 2014. Findings suggest that although performance varied among insurers, insurers overall had roughly comparable financial performance in 2014 as in recent prior years.

In this Policy Insight, the Foundation’s Cristina Boccuti and Tricia Neuman examine how Congress’ effort to permanently stave off scheduled cuts in Medicare’s physician payments could affect what Medicare beneficiaries pay for their care — both in premiums and in other potential changes — to offset the cost of the Sustainable Growth Rate (SGR) “doc fix.”

This perspective addresses how insurance markets might respond if the US Supreme Court sides with the plaintiffs in the King v. Burwell case. The case challenges the legality of premium and cost-sharing subsidies for low- and middle-income people buying insurance in states where the federal government rather than the state is operating the marketplace under the Affordable Care Act (ACA).

This policy insight examines medical debt among insured consumers, exploring how high cost sharing in health insurance plans can contribute, and explaining how greater transparency could help consumers avoid some financial pitfalls. It also provides an update on provisions of the Affordable Care Act meant to increase health plan transparency and bolster consumer assistance.