Coverage

This report examines similarities and differences in federal consumer protection standards for Medicare Advantage (MA) plans, Qualified Health Plans (QHPs), and Medicaid Managed Care Organizations (MCOs). It focuses on rules established at the federal level, though some states have chosen to go above the federal minimums and impose additional requirements for QHPs and Medicaid MCOs.

The Affordable Care Act (ACA) went into full effect on January 1, 2014, ushering in health insurance reforms and new health coverage options in Pennsylvania and elsewhere across the country. Pennsylvania is experiencing changes to its health care delivery system as the state expands Medicaid, provides new coverage options through the federal health insurance marketplace, streamlines application and enrollment processes for coverage programs, and implements new health care delivery system and payment reforms. This fact sheet provides an overview of population health, health coverage, and the health care delivery system in Pennsylvania in the era of health reform.

This fact sheet provides an overview of population health, health coverage, and health care delivery in Ohio under the Affordable Care Act (ACA).

The Affordable Care Act (ACA) went into full effect on January 1, 2014, ushering in health insurance reforms and new health coverage options in Georgia and elsewhere across the country. Thousands of Georgians have enrolled in health coverage through the new Health Insurance Marketplace, but Georgia has not implemented the…

The unwinding of pandemic enrollment protections in Medicaid helped accelerate states’ expansion of eligibility for key groups and adoption of policy and system changes to streamline renewal processes for enrollees, according to findings from a new KFF survey of state Medicaid officials. These changes mean that the return to “routine”…

In his Beyond the Data column, KFF President and CEO Drew Altman discusses how how family health coverage is no longer affordable for workers at small employers, contributing to the health cost crisis affecting the American people.

Noncitizen immigrants, particularly those who are undocumented, face significant barriers to accessing health coverage and care and are significantly more likely than citizens to be uninsured. Some states have taken up options in Medicaid and the Children’s Health Insurance Program (CHIP) to expand coverage for lawfully present immigrants and/or established fully state-funded programs to fill gaps in coverage for immigrants. This brief provides an overview of state health coverage programs for immigrants regardless of status and examines how health coverage for immigrants vary by state coverage policies using data from the 2023 KFF/LA Times Survey of Immigrants.

This Health Policy 101 chapter examines the share of the United States population who are uninsured, highlighting their demographics and the challenges they face because of the lack of coverage. Economic conditions, federal and state policy decisions, and major health crises like the COVID-19 pandemic influence the uninsured rate. While implementation of the Affordable Care Act, namely the expansion of Medicaid and availability of subsidized Marketplace coverage, led to a drop in the share of people who are uninsured, disparities in coverage persist.

This analysis examines who was eligible for Medicare and/or Medicaid between 2002 and 2022 because they received disability benefits from one of the country’s Social Security disability programs, Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). Many who receive SSDI and SSI qualify for both Medicare and Medicaid, known as dual-eligible individuals.

More than two in five (42%) or 57.4 million adults under 65 with private insurance could be eligible under clinical criteria for GLP-1 drugs used to treat people with type 2 diabetes, obesity, or excess weight and weight-related health issues, according to a new KFF analysis. Though only about 3%…