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This Data Note highlights findings from the KFF Consumer Survey on problems consumers have experienced with prior authorization requirements. Overall, those with Medicaid, those who are higher utilizers of care, and those who seek certain types of care such as care for a mental health condition or diabetes encountered more problems with prior authorization over the past year.
Use of digital behavioral health services increased during the COVID-19 pandemic when in-person visits were limited. This brief examines how different types of mental health apps are used, how federal policies during the pandemic affected the scope of services they could provide, and key issues to watch.
The survey finds nearly six in 10 people with health insurance experienced a problem using their insurance in the past year, with even larger shares reporting problems among people who are sick or who have mental health needs. It includes data for people with different types of coverage, including employer, Marketplace, Medicare and Medicaid, and also examines affordability issues and mental health access.
After the public health emergency ends on May 11, private health plans will no longer be required to cover the full cost of COVID-19 tests ordered or administered by a clinician or to reimburse consumers for at-home rapid tests.
This brief examines the evolving requirements for insurers on HealthCare.gov to offer standardized plans that follow set cost sharing rules for covered benefits in addition to other plans they might offer. It also reviews how some state-run marketplaces have used standardized plans to limit cost sharing for insulin, mental health care, and other services.
This brief explains a new proposed federal regulation aimed at reducing administrative hassles involved in obtaining prior authorization for care and sets out key policy questions, including how the proposal could impact the patient experience and data privacy.
This analysis of HealthCare.gov Marketplace insurers' transparency data finds that 17% of in-network claims were denied in 2021, with denial rates varying widely across insurers. Consumers appealed less than two-tenths of 1% of denied in-network claims.
About 5 million people could benefit from the fix to the Affordable Care Act’s “family glitch” that allows workers offered unaffordable family coverage to get subsidies in the marketplace – if they can show they qualify. This brief looks at some of the challenges consumers may face in deciding whether to take advantage of the fix.
This brief discusses federal mental health parity protections -- what they are, who they apply to, who enforces them and key policy issues as Congress and federal agencies evaluate improvements to the law to address gaps in mental health coverage and access.
Most (53%) adults with health care debt say they have received a medical or dental bill they thought contained an error at some point in the past 5 years, and most say a state consumer assistance program would be helpful to them.
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