Individual Market

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.…

In 10 states, insurance plans are currently banned from including abortion as a covered service in state-regulated private plans — all individually purchased policies and fully-insured group plans. Most of these laws do not include exceptions for rape, incest, or health endangerment. In nine of these states, insurers may sell…

This data note explores the extent to which abortion riders are available in the states that restrict abortion coverage in state-regulated private plans and permit insurance carriers to sell abortion riders.

This issue brief reviews current federal and state policies on private insurance coverage of abortion services, and how the Bipartisan Health Care Stabilization Act of 2018 would affect abortion coverage for women enrolled in the individual market.

Facing Such Increases, Some Enrollees Switched To Lower-Cost Coverage People With Pre-Existing Conditions Much More Likely To Report Problems MENLO PARK, CA — People who buy their own insurance report that their insurers most recently requested premium increases averaging 20 percent, according to a new Kaiser survey examining the experiences…

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…

About 88% – nearly nine in ten – enrollees in the individual and fully-insured group markets are covered by plans that have taken action to limit out-of-pocket costs for patients undergoing treatment for COVID-19 since the start of the pandemic. However, after accounting for waivers that have already expired (20%) or are scheduled to expire by the end of September (16%), just over half of enrollees in these plans will still be eligible for waived cost-sharing in October and beyond.

An updated issue brief estimates the number of enrollees in individual and fully-insured group market plans that have waived cost-sharing – out-of-pocket costs including coinsurance, copayments, and deductibles – for COVID-19 treatment. The analysis also estimates the number of enrollees whose insurer is offering various forms of premium payment relief.…