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This brief explains three provisions of the Affordable Care Act (ACA) – risk adjustment, reinsurance, and risk corridors – that were intended to promote insurer competition on the basis of quality and value and promote insurance market stability, particularly in the early years of reform as the ACA marketplaces, also known as exchanges, were established.
Private insurance companies are expecting to pay out $2.1 billion in rebates to consumers this fall, the second highest amount ever issued under the Affordable Care Act, according to a new KFF analysis.
Executive Summary January 1, 2014 marked the beginning of several provisions of the Affordable Care Act (ACA) making significant changes to the non-group insurance market, including new rules for insurers regarding who they must cover and what they can charge, along with the opening of new Health Insurance Marketplaces (also known as “Exchanges”) and the…
This brief estimates the share of adults with pre-existing conditions by metropolitan and micropolitan statistical area (MMSA), and finds that in some areas, nearly four in ten have so-called declinable medical conditions that could lead to denials of individual insurance coverage based on pre-ACA underwriting guidelines.
Key provisions of the 2010 Affordable Care Act (ACA) create new Marketplaces for people who purchase insurance directly and provide new premium tax credits to help people with low or moderate incomes afford that coverage. This analysis estimates that about 17 million people who are now uninsured or who buy insurance on their own (“nongroup purchasers”) will be eligible for premium tax credits in 2014. This issue brief provides national and state estimates for tax credit eligibility for people in these groups.
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 and views of people who buy health coverage in the non-group or individual market.
This fact sheet explains the Medical Loss Ratio requirement under the Affordable Care Act (ACA). The MLR provision limits the portion of premium dollars health insurers may spend on administration, marketing, and profits. Under health care reform, health insurers must publicly report the portion of premium dollars spent on health care and quality improvement and other activities in each state they operate. Insurers failing to meet the applicable standard must pay rebates to consumers and businesses.
Rate review is the process by which insurance regulators review health plans’ new or renewed rates for insurance policies in order to ensure that the rates charged are based on accurate, verifiable data and realistic projections of health costs.
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