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  • Claims Denials and Appeals in ACA Marketplace Plans in 2023

    Issue Brief

    This brief analyzes federal transparency data released by the Centers for Medicare and Medicaid Services (CMS) on claims denials and appeals for non-group qualified health plans (QHPs) offered on HealthCare.gov in 2023. It finds that HealthCare.gov insurers denied nearly one out of every five claims (19%) submitted for in-network services. Information about the reasons for denials is limited, and few consumers appeal claims denials.

  • Children of Immigrants: Key Facts on Health Coverage and Care

    Issue Brief

    This brief provides key data on socioeconomic characteristics and health coverage among children of immigrants based on KFF analysis of the American Community Survey data. It also examines potential implications of policies and actions that may be implemented by the incoming Trump administration.

  • Section 1115 Waiver Watch: A Look at the Use of Contingency Management to Address Stimulant Use Disorder

    Policy Watch

    Contingency management is an evidence-based psychosocial intervention that uses motivational incentives, such as vouchers or gift cards, to encourage recovery behaviors like stimulant abstinence and treatment session (e.g., cognitive behavioral therapy, group therapy) attendance. The Biden administration has approved five state contingency management waivers (California, Delaware, Hawaii, Montana, and Washington); two additional state contingency management requests are currently pending federal review.

  • Key Facts about the Uninsured Population

    Issue Brief

    This issue brief describes trends in health coverage in 2023, examines the characteristics of the uninsured population ages 0-64, and summarizes the access and financial implications of not having coverage.

  • The Twin Problems of Mental Health Care: Access and Affordability

    From Drew Altman

    In this column, KFF President and CEO Drew Altman analyzes the serious access and affordability challenges facing people with mental health problems and suggests the issue could be one of a few candidates for bipartisan action in the next Congress.

  • Medicare Spending was 27% More for People who Disenrolled from Medicare Advantage than for Similar People in Traditional Medicare

    Issue Brief

    This analysis looks at traditional Medicare spending among people who choose to disenroll from Medicare Advantage and obtain coverage under traditional Medicare during the annual Medicare open enrollment period. It compares their traditional Medicare spending (Parts A and B) in the year following disenrollment to similar people who were continuously covered by traditional Medicare, using data from the Medicare Beneficiary Summary File (MBSF) for 2021 and 2022.

  • Health Care Experiences of Native Hawaiian or Pacific Islander Adults

    Issue Brief

    A new issue brief based on focus groups conducted by KFF among NHPI adults living in Hawaii and the continental U.S. highlights barriers NHPI people face when accessing health care, including geographic isolation, limited system capacity, and language access. In their own words, participants describe both positive and negative experiences in health care settings and discuss concerns about mental health in their communities.