Policy Uncertainty is Creating Challenges for ACA Marketplace Insurers
Until Congress passes the reconciliation bill, Marketplace insurers will face uncertainty regarding the regulatory landscape and may find it difficult to set premiums for 2026.
View the Latest: Cost Sharing
Filter
-
-
Make American Health Care Affordable Again
PerspectiveIn this JAMA Health Forum column, Larry Levitt highlights how the Make America Healthy Again agenda aimed at chronic disease does little to address the affordability of health care and that efforts to lower federal spending on health care may worsen the problem, raising out-of-pocket costs for many people with Medicaid and Affordable Care Act coverage.
-
Navigating the Maze: A Look at Patient Cost-Sharing Complexities and Consumer Protections
Issue BriefThis brief focuses on consumers’ understanding of health insurance costs and examines existing federal protections that seek to address barriers to understanding the cost of coverage and care, such as price transparency, self-service price estimator tools, and simplifying cost-sharing designs.
-
New Rule Proposes Changes to ACA Coverage of Gender-Affirming Care, Potentially Increasing Costs for Consumers
Issue BriefThis brief examines a proposed rule that seeks to change how ACA plans would cover gender affirming care services. If finalized the rule could lead insurers to drop coverage or shift costs to individuals and states, making access to gender affirming care more difficult.
-
A Backlash Against Health Insurers, Redux
PerspectiveIn this JAMA Health Forum post, Executive Vice President Larry Levitt recalls the mid-1990s’ public backlash against Health Maintenance Organizations (commonly known as HMOs) – all of which preceded the recent outpouring of health insurance concerns – as well as how consumer protections against coverage restrictions have evolved and fallen short.
-
As Governors Meet in D.C., Possible Federal Medicaid Cuts Loom as Big State Funding Issue
Quick InsightsIn the face of reduced federal funding for Medicaid, states could be left with difficult choices – raise revenue or cut spending. Cuts to Medicaid could mean eliminating coverage for children, parents, working adults or those who might need long term care; limiting benefits; or cutting rates for plans or providers.
-
ACA Preventive Services at the Supreme Court
Quick InsightsIf the Court rules in favor of Braidwood, private health insurers would no longer be required to cover, without cost sharing, certain preventive services recommended by USPTF after 2010 when the ACA was enacted.
-
Medicare Part D in 2025: A First Look at Prescription Drug Plan Availability, Premiums, and Cost Sharing
Issue BriefMedicare Part D is a voluntary outpatient prescription drug benefit for people with Medicare provided through private plans, including stand-alone prescription drug plans and Medicare Advantage plans that offer drug coverage. This analysis provides an overview of Medicare Part D plan availability, premiums, and cost sharing in 2025 and key trends over time.
-
Medicare Advantage Has Become More Popular Among the Shrinking Share of Employers That Offer Retiree Health Benefits
Issue BriefThis analysis examines the extent to which large private and non-federal public employers that offer retiree health benefits are turning to Medicare Advantage and why they are making this shift, using data from the 2024 Employer Health Benefits Survey. We find that slightly more than half (56%) of large employers offering retiree health benefits to Medicare-age retirees offer coverage to at least some retirees through a contract with a Medicare Advantage plan, more than double…
-
Medicare Advantage 2025 Spotlight: A First Look at Plan Offerings
Issue BriefThis brief provides an overview of the Medicare Advantage plans that are available for 2025 and key trends over time. The average Medicare beneficiary will have the option of 34 Medicare Advantage prescription drug (MA-PD) plans in 2025, 2 fewer than the 36 options available in 2024. The average Medicare beneficiary can choose among plans offered by 8 firms in 2025, the same as in 2024.