How Private Health Coverage Works: A Primer – 2008 Update April 1, 2008 Issue Brief How Private Health Coverage Works: A Primer— 2008 Update This primer explains the role and operations of private health coverage in the United States. Private health coverage is provided under a variety of different arrangements, including health insuring organizations regulated under state law and health plans sponsored by employers and employee…
Primers on Key Health Care Topics and Programs December 1, 2008 Issue Brief The Kaiser Family Foundation maintains a number of primers providing overviews of key health care programs and issues. Written by Foundation staff, each primer provides key data and information that helps illustrate the topic and its relevance for the nation’s health care system. Medicaid: A Primer Medicare: A Primer The…
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,…
Health Insurance Market Reforms: Pre-Existing Condition Exclusions October 8, 2012 Fact Sheet Insurers pursue multiple strategies to reduce the cost of covering enrollees with pre-existing conditions, or medical conditions and health problems that existed before the individual enrolled in a health plan. One strategy, the pre-existing condition exclusion, allows insurers to refuse to cover any costs associated with care for a pre-existing…
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…
Peering Into the Black Box of Insurance Rating June 7, 2011 Perspective Recently, the New York Times reported that private health insurers continue to seek large premium increases despite seeing lower than expected use of medical care and booking record profits. The story highlights a significant problem for health policy: the lack of good, public information about how health insurers manage health…
Who Will be the H&R Block and TurboTax for Health Insurance? June 3, 2011 Perspective There’s been quite a bit of focus lately insofar as these issues go, anyway on health insurance agents and brokers (sometimes known in the industry as “producers”). They are pushing legislation that has been introduced in Congress and is now being studied by the National Association of Insurance Commissioners that…
Health Insurance Market Reforms: Portability March 6, 2013 Fact Sheet Most Americans have access to health insurance through an employer-sponsored health plan, a fact that has made changing or losing a job a complex issue for the purposes of maintaining health insurance. Moving to a new job can be hard if the employer does not offer health insurance, or if…
