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This brief and accompanying slides examine cost sharing - deductibles, copayments and coinsurance - in 2016 insurance plans sold on the Affordable Care Act's (ACA) federally-facilitated marketplaces. The analysis looks at out-of-pocket limits, as well as cost sharing for hospital stays, physician visits, emergency room visits, and prescription drugs, for plans across the metal levels (platinum, gold, silver and bronze).
The Affordable Care Act (ACA) requires most private health insurance plans to provide coverage for a broad range of preventive services, including most contraceptives for women. This policy was at the center of a Supreme Court case brought forward by for-profit corporations (Hobby Lobby and Conestoga) that successfully claimed that the contraceptive coverage requirement violated their religious rights. Last month, the Supreme Court agreed to hear yet another challenge (Zubik v Burwell) to the contraceptive…
This analysis focuses on out-of-pocket drug costs for Medicare Part D enrollees in 2016 for specialty, brand, and generic drugs. Part D drug plans differ considerably in the drugs they list on their formularies, their use of formulary tiers, and the level and structure of cost sharing applied to those tiers. Plan decisions affect different beneficiaries in different ways, depending on the drugs they use. The financial consequences for Part D plan enrollees can be…
As the U.S. Supreme Court gears up to hear a new round of legal challenges to the ACA’s contraceptive coverage requirement, a new Kaiser Family Foundation data note finds 10 percent of nonprofits with more than 1,000 employees have requested an "accommodation" to the health law's birth control requirement. Overall, 3 percent of nonprofits with 10 or more employees reported they have sought an accommodation, according to the analysis, which draws from responses to the Kaiser/Health…
In his latest column for The Wall Street Journal‘s Think Tank, Drew Altman explains why prescription drug spending may be a larger share of health spending than most people think, depending on how you look at it. All previous columns by Drew Altman are online.
The YouToons help consumers understand health insurance by explaining health insurance premiums, out-of-pocket costs, and provider networks. These three videos are excerpts from the 2014 YouToons video, Health Insurance Explained – The YouToons Have It Covered.
Following the Affordable Care Act’s (ACA) third open enrollment period, a new Kaiser Family Foundation survey of people who buy their own health insurance finds most marketplace enrollees give their coverage good marks, though concerns about premiums, deductibles, and other costs have risen since 2014. The survey, the third in a series, finds about two thirds (68%) of marketplace customers rate their current coverage as either “excellent” or “good.” Although concerns about narrow network plans…
In this post for The JAMA Forum, Larry Levitt examines both the Democratic candidates' proposals and the Trump administration's record on lowering drug prices, which remains a top issue for the public with bi-partisan support.
This data note captures February 2020 poll findings on the public's worries about and experiences with unexpected and surprise medical bills.
New federal legislation will require most private health plans to cover testing for the coronavirus with no cost sharing. Some states have adopted similar requirements for insurers they regulate, and many private insurance companies will voluntarily expand coverage for testing. However, some private coverage will not be subject to these requirements. To date, fewer changes have been adopted or considered with respect to treatment for complications from the disease. This brief reviews current coverage standards…
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