The Medical Loss Ratio (MLR) provision of the Affordable Care Act (ACA) saved consumers an estimated $2.1 billion last year, in the form of lower premiums and rebates, according to a new analysis by the Kaiser Family Foundation. Under health reform, insurers must issue consumer rebates if they fail to spend a certain portion of premium income on health care claims and quality improvement expenses, thereby limiting what they may spend on administrative expenses or keep as profits.
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With the focus now mainly on exchanges, Medicaid expansions, and enrolling the uninsured in newly available coverage arrangements, there is less attention lately to the ACA insurance reforms which have always been the most popular parts of the law – changes which could affect every American’s insurance in some way…
This policy insight examines the unexpected drop in Medicare’s per-beneficiary spending projections and its implications for beneficiaries and the program’s future.
One year into initial enrollment in the Medicare-Medicaid financial alignment demonstrations for dual eligible beneficiaries, some initial insights are beginning to emerge. This policy insight highlights key challenges and trends emerging in states’ demonstrations.
This Policy Insight outlines eight questions that are likely to shape the U.S. global health response in the last two years of the current presidential term and beyond.
Medical Debt Among Insured Consumers: The Role of Cost Sharing, Transparency, and Consumer Assistance
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.
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.