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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.

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HHS’s Proposed Changes to Non-Discrimination Regulations Under ACA Section 1557

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 proposed rule would narrow the scope of this regulation.

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Ask KFF

Ask KFF: Karen Pollitz Answers 3 Questions on Why Insurers Deny Claims

Karen Pollitz, senior fellow for health reform and private insurance at KFF, answers three questions about denied claims and how the federal government may change the data insurers are required to report on this issue.

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The Henry J. Kaiser Family Foundation

Analysis: Marketplace Plans Denied an Average of Nearly One in Five Claims in 2017 with Wide Variations across Insurers

Healthcare.gov marketplace insurers denied nearly one out of every five claims (19%) submitted for in-network services in 2017, and enrollees only appeal a tiny share (0.5%) of those denied claims, a KFF analysis of recently released claims data finds. The analysis finds a huge variation across insurers, with average denial…

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Claims Denials and Appeals in ACA Marketplace Plans

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 19% of in-network claims were denied by issuers in 2017, with denial rates for specific issuers varying significantly around this average, from less than 1% to more than 40%. Consumers appealed less than 1% of denied claims.

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The Henry J. Kaiser Family Foundation

Para consumidores que estén considerando planes de salud de corto plazo…

Esta hoja informativa ofrece datos sobre los planes de salud de corto plazo y en qué se diferencian de las pólizas que cumplen con ACA.

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ACA Open Enrollment: For Consumers Considering Short-Term Policies…

A short fact sheet provides information about short-term health insurance policies and how they differ from ACA-compliant plans. 

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The Henry J. Kaiser Family Foundation

JAMA Forum: What Does it Mean to Protect People with Preexisting Conditions?

In this June 2018 post for The JAMA Forum, Larry Levitt examines the potential impact of the Trump Administration’s legal challenge to the Affordable Care Act’s protections for people with pre-existing conditions.

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Medigap Enrollment and Consumer Protections Vary Across States

A quarter of people in traditional Medicare had private, supplemental health insurance in 2015—also known as Medigap—to help cover their Medicare deductibles and cost-sharing requirements, as well as protect themselves against catastrophic expenses for Medicare-covered services. This issue brief examines implications for older adults with pre-existing medical conditions who may be unable to purchase a Medigap policy or change their supplemental coverage after their initial open enrollment period.

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Short-Term Limited Duration Plans and HIV

Given the Trump Administration’s promotion of short-term limited-duration (STLD) health insurance policies, this brief examines what they mean for people with HIV. The analysis assesses whether people with HIV could enroll in STLD plans by applying to 38 plans across five states and getting in each case. It also assesses whether such plans could meet basic HIV care and treatment needs for someone diagnosed once enrolled. This finding takes on new importance in light of the Administration’s decision not to defend the ACA and to argue for eliminating pre-existing condition protections.

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