Cost Sharing

In this April 2017 post, Larry Levitt discusses the current status of the Affordable Care Act’s health insurance marketplaces, and explains how the Trump administration’s choices — including whether to continue cost-sharing reduction payments to insurers — could influence stability of the marketplaces going forward. The post is now available at The JAMA Forum.

Premiums, insurer choice, and overall stability of 2018 Affordable Care Act (ACA) marketplaces could be affected by decisions from Congress and the Trump Administration on the health law’s cost-sharing reduction provision. With a legal appeal pending on a lawsuit from the U.S. House, the federal government and Congress are in…

A new Kaiser Family Foundation analysis finds that the average premium for a benchmark silver plan in Affordable Care Act (ACA) marketplaces would need to increase by an estimated 19 percent for insurers to compensate for lost funding if they don’t receive federal payment for ACA cost-sharing subsidies. Established by…

This note illustrates the impact of the cost-sharing reductions in current law by looking at how they affect average deductibles and out-of-pocket maximum limits in benchmark silver plans in 2017 in states using the federally facilitated marketplace.

On the seventh anniversary of the passing of the Affordable Care Act, this Data Note highlights five of the most common misconceptions surrounding the 2010 health care law.

The debate about the future of the Affordable Care Act and its individual insurance marketplaces may be taking the focus off the affordability challenges facing the broader population, most of whom get their health coverage through employers, Medicare or Medicaid. New survey findings from the Kaiser Family Foundation show that…

Michigan and Indiana, led by Republican governors, each obtained a waiver from the Obama Administration to expand Medicaid in ways that differ from the terms of the Affordable Care Act. Notably, both states’ expansions include provisions related to charging enrollees premiums, requiring them to contribute to health accounts and providing…

This brief explains key components of Michigan and Indiana’s Medicaid expansions under Section 1115 demonstration waivers and presents insights from stakeholder interviews and focus groups about early implementation experience.

The Trump Administration and new Congress have indicated that they will seek to cap Medicaid financing through a block grant or per capita cap, reduce federal funding for the program, and offer states increased flexibility to manage their programs within this more limited financing structure. The size of the federal reductions as well as which federal program standards would remain in place and what increased flexibility might be provided to states under such proposals would have significant implications. To help inform discussion around increased flexibility, this brief provides an overview of current federal standards and state options in Medicaid and how states have responded to these options in four key areas: eligibility, benefits, premiums and cost sharing, and provider payments and delivery systems.

As the Trump administration and Republican leadership in Congress begin a new term and seek to repeal the Affordable Care Act (ACA), a new 50-state survey  from the Kaiser Family Foundation offers an in-depth profile of Medicaid and Children’s Health Insurance Program (CHIP) eligibility, enrollment, renewal, and cost sharing policies…