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  • Out-of-Pocket Charges for Rape Kits and Services for Sexual Assault Survivors

    Issue Brief

    Although federal legislation intends to provide no-cost rape kits to all survivors of sexual violence, some survivors still face out-of-pocket charges for minimum standard rape kit services as well as other medical care that takes place following a sexual assault. This brief examines the policies that impact coverage of health care services for survivors of sexual assault and identifies gaps in those programs and coverage for their care, particularly for women with private health insurance.

  • Key Facts on Health and Health Care by Race and Ethnicity

    News Release

    With the COVID-19 pandemic impacting communities of color disproportionately in their health and economic well-being, long-term racial and ethnic disparities have received growing attention. But these inequities in our health system are not new and are a part of larger issues of systemic racism.

  • What to Watch in Medicaid Section 1115 Waivers One Year into the Biden Administration

    Issue Brief

    Section 1115 demonstration waivers provide states an avenue to test new approaches in Medicaid and generally reflect changing priorities from one presidential administration to another. This issue brief summarizes waiver priorities and actions under the Biden Administration as well as pending waiver themes and other issues to watch. If the Build Back Better Act (BBBA) fails to pass or is narrowed significantly, Medicaid waivers and other administrative actions may be a key tool for the Biden Administration to advance policy priorities absent legislation.

  • CMS’s 2020 Final Medicaid Managed Care Rule: A Summary of Major Changes

    Issue Brief

    On November 13, 2020, the Centers for Medicare and Medicaid Services (CMS) finalized revisions to the Medicaid managed care regulations which were proposed in November 2018. CMS previously finalized a major revision to these regulations in 2016. The November 2020 final rule is not a wholesale revision of the 2016 regulations but adopts changes in areas including network adequacy, beneficiary protections, quality oversight, and rates and payment.

  • 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.