Coverage


State Health Facts is a KFF project that provides free, up-to-date, and easy-to-use health data for all 50 states, the District of Columbia, and the United States. It offers data on specific types of health insurance coverage, including employer-sponsored, Medicaid, Medicare, as well as people who are uninsured by demographic characteristics, including age, race/ethnicity, work status, gender, and income. There are also data on health insurance status for a state's population overall and broken down by age, gender, and income.

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  • “Partial Medicaid Expansion” with ACA Enhanced Matching Funds: Implications for Financing and Coverage

    Issue Brief

    The Affordable Care Act (ACA) provides enhanced federal matching funds to states that expand Medicaid to nonelderly adults up to 138% of the federal poverty level (FPL, $17,236/year for an individual in 2019). The ACA enhanced match (93% in 2019, and 90% in 2020 and thereafter) is substantially higher than states’ traditional Medicaid matching rate. A few states have sought Section 1115 demonstration waiver authority from the Centers for Medicare and Medicaid Services (CMS) to receive the substantially higher ACA enhanced match while limiting coverage to individuals at 100% FPL, instead of covering the full 138% FPL ACA group. To date, CMS has allowed states to receive the ACA enhanced Medicaid matching funds only if the entire expansion group is covered. CMS has not approved waiver requests seeking enhanced ACA matching funds for a partial coverage expansion in Arkansas or Massachusetts, while a request is pending in Utah. This brief explores the current rules for partial expansion and explains some of the potential implications for financing and coverage if CMS approves waivers to allow for partial expansion with enhanced matching funds.

  • Are Medicare Advantage Insurers Covering the Cost of At-Home COVID-19 Tests?

    Policy Watch

    The Biden Administration's requirement for private insurers to cover the cost of at-home rapid COVID-19 tests for their enrollees does not apply to Medicare. Medicare Advantage plans (offered by private insurers) have the option to cover at-home tests but are not required to do so. This policy watch examines whether some of the largest private Medicare Advantage plans are covering the cost of at-home rapid tests for COVID-19.

  • Summary of the Affordable Care Act

    Fact Sheet

    This document summarizes the comprehensive 2010 health reform law, often called the Affordable Care Act or ACA, including changes made to it by subsequent legislation, with a focus on provisions to expand coverage, control costs, and improve delivery systems.

  • The Regulation of Private Health Insurance

    Feature

    This Health Policy 101 chapter explores the complex landscape of private health insurance regulation in the United States, detailing the interplay between state and federal regulations that shape access, affordability, and the adequacy of private health coverage. It focuses on key laws such as the Affordable Care Act (ACA) and the Employer Retirement Income Security Act (ERISA), and discusses how regulations impact the private insurance market, illustrating the challenges consumers face in navigating this system.

  • Comparing Trump and Biden on COVID-19

    Issue Brief

    This issue brief compares President Trump and Democratic nominee Joe Biden on their records, actions and proposals related to the COVID-19 pandemic. It includes a general overview of their respective approaches, followed by a detailed side-by-side.

  • Texans’ Experiences with Health Care Affordability and Access

    Report

    Using data from the Kaiser Family Foundation/Episcopal Health Foundation 2018 Texas Health Policy Survey, this brief explores Texas residents’ experiences with health care affordability and access to care. It examines Texans’ difficulty affording health care compared to other basic needs, problems paying medical bills, and skipping or postponing care because of costs. It also explores the experiences of vulnerable groups like the uninsured and those with lower incomes.

  • Health Affairs Blog: The Myth Of The Abortion Insurance Rider

    Perspective

    In a Health Affairs blog post, Laurie Sobel, Caroline Rosenzweig and Alina Salganicoff of the Kaiser Family Foundation discuss the feasibility of abortion riders to private group and individual health plans as a means of providing access to abortion coverage when states ban the coverage as part of an insurance plan.