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  • Optimizing Medicaid Enrollment: Perspectives on Strengthening Medicaid’s Reach Under Health Care Reform

    Issue Brief

    The health reform law creates a national plan for near-universal health coverage that relies on a large expansion of Medicaid eligibility as its foundation. This brief draws on recent interviews with Medicaid program directors and other experts about the opportunities that health reform presents to optimize Medicaid by strengthening its enrollment and renewal operations and recasting it as an affordable health coverage program for working people and families. Executive Summary (.pdf) Issue Brief (.pdf)

  • JAMA Forum: Why Health Insurance Literacy Matters

    Perspective

    Larry Levitt's November 2014 post looks at the challenges with people not understanding basic health insurance concepts as millions of them evaluate and choose health plans during open enrollment season for insurance in 2015.

  • What People Don’t Realize About the Affordable Care Act

    From Drew Altman

    Drew Altman, in The Wall Street Journal’s Think Tank, discusses what people don’t realize about the ACA: it is engineered for variation and it is up to Congress and the states to learn from that variation.

  • Will the Trump Administration Fast Track the Privatization of Medicare?

    Policy Watch

    The privatization of Medicare has been taking place without much public debate – a trend that has implications for the 68 million people covered by Medicare, health care providers, Medicare spending, and taxpayers. It's not yet clear whether the administration will promote policies to accelerate the privatization of Medicare or focus more on achieving efficiencies and savings within Medicare Advantage, or pursue policies that aim to achieve both. How this plays out will have implications…

  • States’ Management of Medicaid Home Care Spending Ahead of H.R. 1 Effects

    Issue Brief

    Using data from the 23rd KFF survey of officials administering Medicaid home care programs, this issue brief describes the mechanisms states are currently using to limit Medicaid spending on home care and their plans for adopting new mechanisms in state fiscal year (FY) 2026.

  • Medicaid Enrollment & Spending Growth: FY 2025 & 2026

    Issue Brief

    This brief analyzes Medicaid enrollment and spending trends for FY 2025 and FY 2026, based on data provided by state Medicaid directors as part of the 25th annual survey of Medicaid directors.

  • Recent Trends in Commercial Health Insurance Market Concentration

    Issue Brief

    Commercial health insurance markets remain highly concentrated across coverage types. However, the individual market, which consists mostly of the ACA Marketplaces, has attracted more insurers and witnessed greater insurer competition across a variety of measures since the implementation of the enhanced premium tax credits in 2021, according to a new Healthy System Tracker analysis.

  • Enrollment Growth in the ACA Marketplaces

    Policy Watch

    This analysis of enrollment in Affordable Care Act (ACA) Marketplace health plans finds a record 24.3 million people enrolled in 2025, more than double the total in 2020, with most of the growth occurring in states won by President Trump in the 2024 election. In six states, enrollment more than tripled from 2020 to 2025: Texas, Mississippi, West Virginia, Louisiana, Georgia, and Tennessee.

  • 10 Things to Know About the Unwinding of the Medicaid Continuous Enrollment Provision

    Issue Brief

    Medicaid enrollment increased since the start of the pandemic, primarily due to the continuous enrollment provision.KFF estimates that between 8 million and 24 million people will lose Medicaid coverage during the unwinding of the continuous enrollment provision.The Medicaid continuous enrollment provision stopped “churn” among Medicaid enrollees.States approaches to unwinding the continuous enrollment provision vary.Maximizing streamlined renewal processes can promote continuity of coverage as states unwind the continuous enrollment provision.States have obtained temporary waivers to pursue…