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

    News Release

    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 fully-insured market, the analysis finds. The future of these markets has become a focus for policymakers amid the debate over Medicare for All. Some proposals…

  • Sizing Up Exchange Market Competition

    Issue Brief

    This issue brief offers an early look into how competitive the health insurance exchanges (also called marketplaces) are under the Affordable Care Act in selected states. Through analysis of enrollment data released by seven states (California, Connecticut, Minnesota, New York, Nevada, Rhode Island, and Washington) this brief finds that exchange markets in California and New York are shaping up to be more competitive than their individual markets were in 2012 while those of Connecticut and…

  • Obamacare and You

    Fact Sheet

    Obamacare and You is a series of one-page papers explaining how the Affordable Care Act, also known as “Obamacare,” will affect different groups of people. Click on the links below to learn more: If You Are Uninsured  Haga clic para leer en español  If You Are Low-Income and May Qualify for Medicaid  Haga clic para leer en español If You Have a Pre-Existing Condition Haga clic para leer en español If You Buy Coverage in the Individual Market…

  • Pulling it Together: What Conservatives Are Winning

    Perspective

    Conservatives are out of sorts these days about the direction in which health care is headed. They think the new health reform law expands the role of government too much and spends too much at a time when they believe deficit reduction should be a higher priority. The claims about death panels and a government takeover of the health system aside, these are principled positions for conservatives to take – they are supposed to be…

  • Summary: National Survey of Enrollees in Consumer-Directed Health Plans

    Poll Finding

    This survey summary provides an in-depth analysis of the National Survey of Enrollees in Consumer-Directed Health Plans conducted between June 21 and July 10, 2006. The survey looks at the views and experiences of people enrolled in consumer-directed health plans as compared to people with traditional health insurance. Survey Summary (.pdf)

  • Essential Health Benefits: Balancing Affordability and Adequacy

    Event Date:
    Event

    Under the Patient Protection and Affordable Care Act (PPACA), insurance plans offered through state insurance exchanges as well as non-grandfathered plans offered in the individual and small group markets - will be required to cover a set of health benefits and services called the "essential health benefits" package. Guidance issued last month by the Department of Health and Human Services will give each state some discretion to specify benefits package raises many questions. What is…

  • How Accessible is Individual Health Insurance for Consumers in Less-Than Perfect Health?

    Report

    This report documents the findings of a study examining access to health insurance coverage in the individual market for people with health problems. Seven hypothetical consumers with varying health conditions were defined and insurers and HMOs in eight different markets around the country were asked to consider them as though they were real consumers applying for coverage. Renewed debate over proposals to expand coverage for the uninsured using tax credits for the purchase of individual…

  • How Private Insurance Works: A Primer

    Report

    This primer, prepared by Gary Claxton of the Institute for Health Care Research and Policy at Georgetown University, examines the structure and operation of private health insurance including the types of organizations that provide it, how managed care is delivered, and how risk pools work and describes how private health insurance coverage is regulated under state and federal laws. The primer explains how the current nature of private insurance relates to key issues facing federal…

  • Understanding Individual Health Insurance Markets

    Other Post

    : Structure, Practices, and Products in Ten States New Study of Individual Health Insurance Market: Major Barriers Identified in Individual Health Insurance Market for People with Health Problems. Rates and Regulations Vary Across Ten States Studied Denials, Waiting Periods, and High Premiums Pose Problems for Pre-Medicare Population For Immediate Release Tuesday, March 17, 1998 Washington, DC - For many people who have health problems or who are approaching the age of retirement, coverage through the…