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Marketplace Insurers Denied Nearly 1 in 5 In-Network Claims in 2020, though It’s Often Not Clear Why

Jul 5, 2022

News Release

Healthcare.gov marketplace insurers denied nearly one out of every five claims (18%) submitted for in-network services in 2020, though why the denial rates are so high and the ultimate consequences for consumers are difficult to access from the publicly available data, a new KFF analysis finds. The Affordable Care Act requires insurers to report data about claims denials and appeals to encourage transparency about how insurance coverage works for enrollees. The analysis examines data released…

Unwinding of the PHE: Maintaining Medicaid for People with Limited English Proficiency

Mar 3, 2022

Issue Brief

Provisions in the Families First Coronavirus Response Act (FFCRA) require states to maintain continuous Medicaid enrollment for enrollees until the end of the month when the COVID-19 public health emergency (PHE) ends. When the continuous enrollment requirements end and states resume redeterminations and disenrollments, individuals with LEP may be at increased risk of losing Medicaid coverage or experiencing a gap in coverage due to barriers completing these processes, even if they remain eligible for coverage.

Medicare Advantage Is Close to Becoming the Predominant Way That Medicare Beneficiaries Get Their Health Coverage and Care

Aug 25, 2022

News Release

As Medicare Advantage continues to grow, a gradual but significant reshaping of the Medicare program is taking place. A new KFF analysis finds that nearly half of eligible Medicare beneficiaries – 28.4 million out of 58.6 million Medicare beneficiaries overall – are now enrolled in Medicare Advantage plans. That represents a more than doubling of the share of the eligible Medicare population enrolled in such plans from 2007 to 2022 (19% to 48%). Enrollment is…

How Does the ACA Expansion Affect Medicaid Coverage Before and During Pregnancy?

Oct 26, 2022

Issue Brief

This brief looks at length of Medicaid coverage before delivery among enrollees with a live birth in Medicaid Expansion and non-Expansion states using the 2019 T-MSIS data.

The Affordability of Long-Term Care and Support Services: Findings from a KFF Survey

Nov 14, 2023

Poll Finding

This survey shows that most adults feel unprepared for affording the cost of long-term care and support service, and just under half are not confident they will have the financial resources to pay for care they might need as they age. Most older adults have not taken financial or practical steps to plan for their potential future care needs.

Medicaid Financial Eligibility in Pathways Based on Old Age or Disability in 2022: Findings from a 50-State Survey

Jul 11, 2022

Issue Brief

This issue brief presents state-level data on Medicaid financial eligibility criteria and adoption of the major non-MAGI pathways as of January 2022. The data were collected from March through May 2022 in KFF’s survey of Medicaid state eligibility officials.

Ending COVID-19 Emergency Declarations Will Bring an End to Flexibilities that Aided Patients, Providers, Insurers, and Public Programs in Responding to the Pandemic

Apr 8, 2022

News Release

When the federal government ends COVID-19 emergency declarations that were declared in the early days of the pandemic, it will bring to a close several changes that were enacted temporarily to enable the U.S. health care system to better deal with the crisis. A new KFF resource details a number of those flexibilities and lays out what it will mean for people, providers and federal health programs when they go away. One of the key…

KFF Health Tracking Poll July 2023: The Public’s Views Of New Prescription Weight Loss Drugs And Prescription Drug Costs

Aug 4, 2023

Feature

About half of adults are interested in taking prescription weight loss drugs. though interest drops when presented with obstacles or drawbacks. Many adults struggle with affording prescription drugs and say there should be more price regulation. Few are aware of provisions in the 2023 Inflation Reduction Act aimed at lowering the drug price for Medicare beneficiaries

Despite Improvements, Racial and Ethnic Disparities in Cancer Mortality Rates Persist

Feb 3, 2022

Feature

Overall cancer mortality rates have decreased for all racial and ethnic groups, with the largest decrease among Black people. However, Black people continued to have the highest risk of cancer death.

Price Regulation, Global Budgets, and Spending Targets: A Road Map to Reduce Health Care Spending, and Improve Affordability

May 31, 2022

Report

We review several policy options to constrain health care spending, primarily by putting downward pressure on provider prices, including price regulation, global budgets, and spending growth targets.

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