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  • Visualizing Health Policy: Health Coverage Under the Affordable Care Act (ACA)

    Report

    Related Resources Study Highlights Role of Geography and Plan Shopping Under Medicare Premium Support System Medicare Part D: A First Look at Part D Plan Offerings in 2013 The Medicare Prescription Drug Benefit - An Updated Fact Sheet Online Consumer Guide to Medicare   The latest Visualizing Health Policy infographic is a flowchart illustrating the mechanisms by which people will get health coverage beginning in 2014. Medicare's Role and Future Challenges << Previous Visualizing Health…

  • Health Insurance Market Reforms: Rate Review

    Fact Sheet

    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. Historically, state insurance departments have conducted rate review, but under the Affordable Care Act (ACA), federal regulators may review rate increases in some cases. This fact sheet explains how rate review works and how the ACA…

  • Quick Take: Essential Health Benefits: What Have States Decided for Their Benchmark?

    Fact Sheet

    Beginning on January 1, 2014, the Affordable Care Act (ACA) requires that all non-grandfathered individual and small group health insurance plans sold in a state, including those offered through an Exchange, cover certain essential health benefits (EHBs). As it stands today, many plans offered in the individual and small group markets lack access to key benefits; the Department of Health and Human Services (HHS) estimates that 62% of health plan enrollees in the individual market…

  • Health Insurance Market Reforms: Pre-Existing Condition Exclusions

    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 condition permanently or over a period of time. Beginning January 1, 2014, insurers in the individual and group markets will be prohibited from imposing pre-existing…

  • Quantifying the Effects of Health Insurance Rate Review

    Report

    This report from the Kaiser Family Foundation analyzes the effect of government efforts to ensure that insurance premium increases are justifiable and provide value to consumers and small businesses. Rate review programs require insurers in the small group and individual markets to submit proposed rate increase requests to state or federal regulators, who determine if the requests are reasonable. The report finds that one out of every five requests submitted to states in 2011 resulted…

  • How Small Business Owners Get Health Insurance

    Perspective

    As with any economic policy issue, there has been much discussion of how the Affordable Care Act (ACA) will affect small businesses. But, there’s been very little focus on how the health reform law will affect the owners of those businesses as people. As our recently released Employer Health Benefits Survey shows, small businesses are much less likely than larger businesses to offer health benefits to their workers. Half of businesses with 3-9 workers and…

  • Summary of Coverage Provisions in the Patient Protection and Affordable Care Act

    Issue Brief

    This short summary describes the health coverage provisions contained in the final version of the Affordable Care Act signed into law in March 2010, including the individual mandate requirements, expansion of public programs, health insurance exchanges, changes to private insurance and employer requirements.

  • Is a Death Spiral Inevitable If There is No Mandate?

    Perspective

    If the Supreme Court acts within the next couple of weeks to overturn the individual mandate in the Affordable Care Act (ACA) while leaving the rest of the law intact, expect to hear a lot about how the individual insurance market will be destined for a "death spiral." When compared with implementing the ACA in full as planned, there's a consensus that eliminating the mandate would increase premiums and mean that far fewer of the…

  • Kaiser Survey Probes Health Insurance Brokers’ Views on Insurance Trends, ACA

    Perspective

    A new nationally representative survey of 500 health insurance agents and brokers working in the individual and small group markets by the Kaiser Family Foundation explores their outlook on market trends and views on the Affordable Care Act (ACA). The survey finds that many agents are seeing steep increases in premiums and deductibles for individuals and small businesses purchasing health insurance. When asked to estimate what they expect to be the typical premium increase in 2012…

  • The High and Rising Costs Of Health Care: What Can Be Done?

    Event Date:
    Event

    The Alliance for Health Reform, the Kaiser Family Foundation, and several cosponsors held the final event in a three-part series of discussions on costs, the factors driving them up and what (if anything) can be done about them. This briefing and others in the series take an in-depth look at a select few of the most often cited health care cost drivers. This briefing focuses on efforts to improve health and health care at lower…