Kaiser Analysis: Estimated Health Insurance Rebates Under the Health Reform Law Total $1.3 Billion in 2012 April 1, 2012 News Release NEWS RELEASE April 26, 2012 Rebates Expected to Vary Significantly by State MENLO PARK, Calif. – Consumers and businesses are expected to receive an estimated $1.3 billion by this August in rebates from health insurers who spent more on administrative expenses and profits than allowed by the Affordable Care Act…
Patient Cost-Sharing Under the Affordable Care Act April 1, 2012 Report Under the Affordable Care Act (ACA), four tiers of health insurance will be offered in the health insurance exchanges and throughout the individual and small group markets beginning in 2014. Under the minimum coverage plan, the “Bronze” plan, the insurance plan will pay for 60 percent of the costs of…
The Diversity of Dual Eligible Beneficiaries: An Examination of Services and Spending for People Eligible for Both Medicaid and Medicare April 1, 2012 Issue Brief This issue brief analyzes linked Medicare and Medicaid data to examine dual eligibles’ utilization and spending in both programs in 2007. As a group, dual eligibles are costly—with per capita Medicare and Medicaid spending over four times Medicare spending for other beneficiaries. However, a small share of dual eligibles account…
Among Dual Eligibles, Identifying The Highest Cost Individuals Could Help In Crafting More Targeted And Effective Responses April 1, 2012 Report This Health Affairs article by researchers at the Urban Institute analyzes linked Medicare and Medicaid data to examine dual eligibles’ utilization and spending in both programs in 2007. It finds that while the population of people dually eligible for Medicare and Medicaid is indeed costly, it is not monolithic. For…
Insurer Rebates under the Medical Loss Ratio: 2012 Estimates April 1, 2012 Report Beginning in 2011, the Affordable Care Act (ACA) requires insurance plans to pay out a minimum percentage of premium dollars towards health care expenses and quality improvement activities, limiting the amount spent on administrative and marketing costs and profit. Under the law, large group plans are required to spend at…
AIDS in Gay America: Findings from Focus Groups March 30, 2012 Report Between January and March 2012, the Kaiser Family Foundation and the Black AIDS Institute conducted focus groups in Philadelphia, Los Angeles and Dallas with men self-identifying as gay or bisexual to provide insight as to how HIV/AIDS is viewed in the gay community today, what actions are being taken to…
Using Data and Technology to Drive Process Improvement in Medicaid and CHIP: Lessons From South Carolina March 30, 2012 Fact Sheet In the past year, there has been a notable trend of states increasingly utilizing data and technology to modernize, streamline, and gain efficiencies in their Medicaid and CHIP programs. The expanded use of data and technology is not only helping states deal with current budget pressures and decreased administrative resources,…
The Health Reform Law’s Medicaid Expansion: A Guide to the Supreme Court Arguments March 29, 2012 Issue Brief One significant element of the pending U.S. Supreme Court case challenging the Affordable Care Act is the constitutionality of the law’s Medicaid expansion. This provision of the law requires states that choose to participate in the Medicaid program to cover nearly all adults under age 65 with household incomes at…
A Guide to the Medicaid Appeals Process March 29, 2012 Issue Brief This background brief provides a comprehensive look at the appeals process for the Medicaid program, which differs significantly from those available through the Medicare program and private health insurance. The Medicaid appeals process provides redress for individual applicants and beneficiaries seeking eligibility for the program or coverage of prescribed services,…
The Role of the Basic Health Program in the Coverage Continuum: Opportunities, Risks & Considerations for States March 28, 2012 Issue Brief This brief assesses the potential benefits and drawbacks to states from implementing a Basic Health Program under the Affordable Care Act. The law gives states the option of creating a Basic Health Program, using federal tax money to subsidize insurance coverage for low-income residents who would otherwise be eligible to…
