Based on an analysis of transparency data released by the Centers for Medicare and Medicaid Services (CMS), this brief assess claims denials and appeals among issuers offering individual market coverage on healthcare.gov and finds that 17% of in-network claims were denied by issuers in 2019, with denial rates for specific issuers varying significantly around this average, from less than 1% to more than 50%. Consumers appealed less than 1% of denied claims.
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In this perspective published by the Washington Post, KFF Executive Vice President for Health Policy Larry Levitt explains why the popular Affordable Care Act provisions that ensure people with pre-existing conditions can access affordable health insurance can’t easily be preserved if other related provisions are overturned.
The Trump Administration’s Final Rule on Section 1557 Non-Discrimination Regulations Under the ACA and Current Status
Section 1557 of the Affordable Care Act prohibits discrimination based on race, color, national origin, sex, age, and disability in health programs and activities receiving federal funds. Here are the significant ways HHS’s final rule would narrow the scope of this regulation.
This analysis examines list prices for COVID-19 testing at the largest hospitals in every state and finds they range widely from $20 to $850. Federal law now requires private insurers to cover COVID-19 tests at no cost to the patient and provides funding for people without health insurance.
In an Axios column, Drew Altman previews new data highlighting that people with critical health issues are especially vulnerable to these bills.
Ahead of the annual Affordable Care Act (ACA) open enrollment period, the time during which consumers can shop for health plans or renew existing coverage, KFF has updated and expanded its searchable collection of more than 300 Frequently Asked Questions about open enrollment, the health insurance marketplaces and the ACA.…
A short fact sheet provides information about short-term health insurance policies and how they differ from ACA-compliant plans.
This analysis estimates that almost 54 million people – or 27% of all adults under 65 —have pre-existing health conditions that would likely have made them uninsurable in the individual markets that existed in most states before the Affordable Care Act. Almost half (45%) of non-elderly families include at least one adult with such a pre-existing condition. The analysis also includes estimates by age, state and gender.
KFF is pleased to announce that Kaiser Health News (KHN), its editorially independent health news service, won a top prize in the 13th annual Barlett & Steele Awards for Investigative Journalism.
Brief Examines Proposed Changes to Federal Anti-Discrimination Protections in Health Care that Would Limit Protections related to Gender Identity, Access to Abortion and Language Access
A new brief analyzes the Trump Administration’s proposed changes to federal anti-discrimination regulations that would eliminate existing protections in health care related to gender identity and access to abortion, and narrow protections for non-English speakers.