ACA Marketplaces - Research and Data from KFF

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…

2022 Health Insurance Marketplace Calculator

May 27, 2022

Interactive

The Health Insurance Marketplace Calculator, updated with 2022 premium data, provides estimates of health insurance premiums and subsidies for people purchasing insurance on their own in health insurance exchanges (or “Marketplaces”) created by the Affordable Care Act (ACA).

The Uncertain Future of Policies to Promote Access and Affordability Put in Place During the COVID-19 Pandemic

May 19, 2022

Perspective

In this column for the JAMA Health Forum, Larry Levitt highlights four changes implemented during the COVID-19 pandemic that helped to make health care more accessible and affordable and the prospects for those changes to telehealth, COVID-19 coverage, Medicaid and marketplace premiums continuing beyond the pandemic’s end.

For ACA Enrollees, How Much Premiums Rise Next Year is Mostly up to Congress

May 18, 2022

Policy Watch

Most customers with coverage through Affordable Care Act's marketplaces will face big premium increases next year if Congress doesn’t extend the temporary enhanced tax credits included in the American Rescue Plan Act (ARPA) of 2021. If the outcome isn’t clear by summer, fall open enrollment could be a mess.

Many Workers, Particularly at Small Firms, Face High Premiums to Enroll in Family Coverage, Leaving Many in the ‘Family Glitch’

Apr 12, 2022

Issue Brief

Data from the KFF Employer Health Benefits Survey demonstrates that some workers face very high contribution amounts for family coverage, including 12% who would have pay at least $10,000 annually in premiums for a family of four. These are the workers most likely to benefit from a fix to the 'family glitch'.

Without Build Back Better, Will the End of the Public Health Emergency Leave Even More People Uninsured?

Mar 2, 2022

Policy Watch

Continuous enrollment in Medicaid and enhanced premium assistance have helped millions afford and maintain coverage, but those gains could be reversed as the public emergency ends and if the provisions like those in the Build Back Better Act fail to pass.

Network Adequacy Standards and Enforcement

Feb 4, 2022

Issue Brief

Health plan networks affect patient access to care. This brief reviews options for setting and enforcing network adequacy standards and tools for making differences in plan networks more transparent.

Build Back Better Would Change the Ways Low-Income People get Health Insurance

Dec 14, 2021

Issue Brief

The Build Back Better Act would make a number of changes to the way people get health insurance and how health care is financed, including by temporarily closing the Medicaid coverage gap.

County-Level Analysis Finds ACA Premiums are Falling in Many Areas of the Country, Though Changes Vary by County and Type of Plan

Dec 7, 2021

News Release

Premiums for the Affordable Care Act Marketplace benchmark silver plan are decreasing 3.1 percent on average across the country – the fourth year in a row that benchmark premiums have fallen – though the changes vary by county, a new KFF county-by-county analysis finds. The benchmark plan premiums are important because they are used to determine the tax credits available to people who buy their own insurance through the Marketplaces. What people would have to…

Efforts to Increase Marketplace Enrollment During Open Enrollment Could Boost Medicaid Coverage, Too

Nov 4, 2021

Policy Watch

As the ninth open enrollment period for the Health Insurance Marketplaces begins, enhanced Marketplace premium help along with increased funding for outreach and enrollment assistance mean there are more affordable coverage options for the millions of people who remain uninsured and more help available to connect those individuals to coverage.

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