Controlling Health Insurance Premiums: Perspectives from the States, the Federal Government and Industry September 19, 2011 Event The Affordable Care Act creates a process for states and the Department of Health and Human Services to review “unreasonable” premium increases and provide information to consumers about the process. The rules governing this rate review process went into effect September 1, 2011. This briefing by the Kaiser Family Foundation,…
Protection in Managed Care Plans: A Side-by-Side Comparison of Proposal Federal Legislation June 29, 1997 Report Protection in Managed Care Plans: A Side-by-Side Comparison of Proposed Federal Legislation. A side-by-side comparison of the provisions for consumer protection in managed care plans contained in the House and Senate budget reconciliation bills and in eight other consumer protection bills currently under consideration by Congress. These bills, which would…
The Impact of Managed Care Legislation: An Analysis of Five Legislative Proposals from California October 30, 1997 Report This study analyzed five 1997 managed care consumer protection proposals currently or recently under consideration by the California state legislature: allowing consumers to sue their HMO (health maintenance organization) or managed care plan; expanding access to prescription drugs not approved by the health plan; expanded coverage of mental health services;…
Managed Care Plan Liability: An Analysis of Texas and Missouri Legislation October 30, 1997 Report This report analyzes recently enacted laws in Texas and Missouri that expand consumers' ability to sue their HMOs or other managed care plans for inappropriately denied care or similar problems.Report Report
External Review of Health Plan Decisions — Policy Brief December 30, 1998 Issue Brief An 8-page policy brief on the external review of health plan decisions to inform the policy debate in California and nationally. The policy brief covers external review systems in other states and the Medicare program, the current status of external review in California, and issues regarding the design and implementation…
Retiree Health Benefits in 2003: Employer Survey December 31, 2003 Report This survey, conducted by the Kaiser Family Foundation and Hewitt Associates between June and September 2003 provides detailed information on retiree health programs offered by large private-sector employers. The data in this survey reflect the responses of 408 large firms (private-sector employers with 1,000 or more workers) and provides information…
Issues for Structuring Interim High-Risk Pools December 30, 2009 Issue Brief One of the first provisions that would be implemented under federal health reform bills in the House and the Senate would establish a national high-risk pool program to offer coverage to otherwise uninsurable individuals during the interim period between enactment and implementation of broader health care reforms. High-risk pools provide…
Statement of Gary Claxton to NAIC Exchanges (B) Subgroup July 22, 2010 Event Kaiser Family Foundation Vice President Gary Claxton, who directs the Foundation’s Marketplace Policy Project, testified July 22, 2010, at a public hearing before the National Association of Insurance Commissioners’ Exchanges (B) Subgroup established by the health reform law. Testimony (.pdf)
Insurer Rebates under the Medical Loss Ratio: 2012 Estimates April 1, 2012 Report Beginning in 2011, the Affordable Care Act (ACA) requires insurance plans to pay out a minimum percentage of premium dollars towards health care expenses and quality improvement activities, limiting the amount spent on administrative and marketing costs and profit. Under the law, large group plans are required to spend at…
In Pursuit of Affordable Health Care: On the Ground Lessons From Families in Massachusetts August 30, 2009 Report This report, based on focus groups with adults in a variety of circumstances, highlights the experiences of Massachusetts residents in obtaining health coverage, accessing health care services and managing out-of-pocket costs in the wake of the state’s 2006 health reform law. Report (.pdf)
