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Private Insurers Are Expected to Pay a Record of At least $1.3 Billion in Rebates to Consumers Beginning in September for Excessive Premiums Relative to Health Care Expenses

Private insurance companies are expecting to pay out a record of at least $1.3 billion in rebates to consumers this fall based on their share of premium revenues devoted to health care expenses in recent years, surpassing the previous record high of $1.1 billion in 2012, according to a new…

As Policymakers Debate Medicare-for-All, Analysis Finds the Medicare Advantage, Individual and Group Health Insurance Markets Appear to Be Profitable, Especially Medicare Advantage

Three key private health insurance markets — Medicare Advantage, the individual market and the fully-insured group market — appear to be financially healthy and attractive to insurers, according to a new KFF analysis. The private Medicare Advantage market generates significantly larger gross margins per person than the individual market or…

Financial Performance of Medicare Advantage, Individual, and Group Health Insurance Markets

Three key private health insurance markets — Medicare Advantage, the individual market and the fully-insured group market — appear to be financially healthy and attractive to insurers. The private Medicare Advantage market generates significantly larger gross margins per person than the individual market or fully-insured market. The future of these markets has become a focus for policymakers amid the debate over Medicare for All.

State Actions to Improve the Affordability of Health Insurance in the Individual Market

A number of states have taken steps to provide consumers with more affordable coverage options in the individual market, including the marketplaces. Some states are implementing strategies that lower premiums by building on, and increasing the stability of the individual market, while other states are expanding the availability of lower cost coverage sold outside the marketplaces that does not comply with ACA standards—an approach that could increase marketplace premiums further. This brief examines these different approaches and discusses the implications of state policy choices.

Among People Ineligible for Subsidies, Middle-Class Older Adults Face the Least Affordable ACA Premiums, Especially Those Living in Rural Areas Where Premiums Are Highest

A new KFF analysis finds that Affordable Care Act marketplace premiums are least affordable for older adults who earn too much to qualify for federal subsidies, especially those living in rural areas where premiums are highest. The analysis of the lowest-cost 2019 ACA marketplace plans across U.S. counties finds that…

How Affordable are 2019 ACA Premiums for Middle-Income People?

This analysis finds that Affordable Care Act marketplace premiums are least affordable for older adults who earn too much to qualify for federal subsidies, especially those living in rural areas where premiums are highest. The analysis also discusses a variety of state and federal proposals that seek to lower premiums for middle-class people buying their own insurance who are ineligible for ACA subsidies.

Testimony: Pre-Existing Conditions and Health Insurance

KFF’s Karen Pollitz testimony before the U.S. House Committee on Ways and Means on Jan. 29, 2019 examines the prevalence of pre-existing conditions, the impact of the Affordable Care Act’s prohibition against medical underwriting and other provisions aimed at stabilizing the insurance risk pool, and the trade-offs involved in relaxing those provisions.