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Data Note: 2022 Medical Loss Ratio Rebates

We find that insurers estimate they will issue a total of about $1 billion in Medical Loss Ratio (MLR) rebates this year across all commercial markets under a provision of the Affordable Care Act (ACA) that limits the share of premiums that insurers can keep for administration, marketing, and profits.

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Private Insurers Expect to Pay $1 Billion in Rebates to Consumers This Year for Setting Premiums Too High Relative to Medical Costs

Private insurance companies are expecting to pay out $1 billion in rebates to consumers this fall under an Affordable Care Act provision that requires insurers to spend the bulk of customers’ premium payments on care, a new KFF analysis finds. Rebates are based on insurers’ experiences over the previous three…

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For ACA Enrollees, How Much Premiums Rise Next Year is Mostly up to Congress

Most customers with coverage through Affordable Care Act’s marketplaces will face big premium increases next year if Congress doesn’t extend the temporary enhanced tax credits included in the American Rescue Plan Act (ARPA) of 2021. If the outcome isn’t clear by summer, fall open enrollment could be a mess.

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Many Privately Insured People with Diabetes Could Save Money if Congress Caps Insulin Costs

Several legislative proposals in Congress propose a $35 per month cap on what people with health insurance would have to pay out of pocket for insulin, a life-saving hormone taken regularly by many people with diabetes to maintain their health. Such a cap could provide financial relief to at least…

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County-Level Analysis Finds ACA Premiums are Falling in Many Areas of the Country, Though Changes Vary by County and Type of Plan

Premiums for the Affordable Care Act Marketplace benchmark silver plan are decreasing 3.1 percent on average across the country – the fourth year in a row that benchmark premiums have fallen – though the changes vary by county, a new KFF county-by-county analysis finds. The benchmark plan premiums are important…

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How ACA Marketplace Premiums Are Changing by County in 2022

Premiums for ACA Marketplace benchmark silver plans are decreasing on average across the U.S. in 2022. However, premium changes vary widely by location and by metal level, including premium increases in a number of counties and plans.

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Explaining Health Care Reform: Questions About Health Insurance Subsidies

This brief provides an overview of the financial assistance provided under the ACA for people purchasing coverage on their own through health insurance Marketplaces (also called exchanges).

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Insurer Filings Suggest COVID-19 Pandemic Will Not Drive Health Spending In 2022

This brief reviews initial 2022 premium rate filings for Marketplace-participating individual market insurers in 13 states and the District of Columbia. Most expect health utilization patterns to return to pre-pandemic levels and therefore not factoring in any impact on their 2022 premiums.

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Navigator Funding Restored in Federal Marketplace States for 2022

This data notereviews the data from CMS about its funding awards to Navigator programs serving consumers in the federal marketplace states during the 2022 open enrollment season, as well as funding trends over time and funding by state.

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California.