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  • Nearly 54 Million Americans Have Pre-Existing Conditions That Would Make Them Uninsurable in the Individual Market without the ACA

    News Release

    Almost Half of Non-Elderly Families have At Least One Adult with a Pre-Existing Condition An updated KFF analysis estimates that almost 54 million people – or 27% of all adults under 65 —have pre-existing health conditions that would likely have made them uninsurable in the individual markets that existed in most states before the Affordable Care Act. The share of adults under 65 with such declinable pre-existing conditions varies significantly across states, from at least…

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

    Poll Finding

    This chart pack provides data and analysis from 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. Chartpack (.pdf)

  • Explaining Health Care Reform: What is Health Insurance?

    Issue Brief

    A key element in any comprehensive health reform plan is defining what health insurance is and the amount of insurance coverage people will have. There are two components to that coverage: the types of services covered (e.g., physician care, hospitalization, prescription drugs, etc.), and the cost sharing required of enrollees (e.g., the annual deductible, the copayments or coinsurance, and the maximum out-of-pocket costs for a year). The overall approach to reform drives the kinds of…

  • Kaiser Analysis: Estimated Health Insurance Rebates Under the Health Reform Law Total $1.3 Billion in 2012

    News Release

    NEWS RELEASEApril 26, 2012 Rebates Expected to Vary Significantly by State MENLO PARK, Calif. – Consumers and businesses are expected to receive an estimated $1.3 billion by this August in rebates from health insurers who spent more on administrative expenses and profits than allowed by the Affordable Care Act (ACA), finds a new analysis from the Kaiser Family Foundation of the latest estimates provided by insurers to state insurance commissioners. The rebates include $541 million…

  • How Non-Group Health Coverage Varies With Income

    Report

    With some federal and state policy makers considering ways to encourage more people to purchase non-group, or individual, health care coverage, this new analysis by Kaiser Family Foundation researchers examines how often people at different income levels buy such coverage when they do not have access to employer coverage or do not obtain public coverage. The analysis finds that relatively few people at lower incomes purchase non-group coverage, with one in 20 purchasing it among…

  • 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…

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

    Issue Brief

    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…

  • Testimony: Pre-Existing Conditions and Health Insurance

    Issue Brief

    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. 

  • Some Can Get Marketplace Plans With No Premiums,Though With Higher Deductibles and Cost-Sharing

    News Release

    Many low-income consumers who are eligible for federal financial help under the Affordable Care Act can get a bronze-level plan and pay nothing out-of-pocket in premiums in more than 2,000 counties next year, depending on their annual income, according to a new analysis from KFF (the Kaiser Family Foundation). Such plans come with higher deductibles and out-of-pocket maximums, however. The analysis finds that the ACA’s premium tax credits would cover the full premium of the lowest-cost bronze…

  • New Rules for Section 1332 Waivers: Changes and Implications

    Issue Brief

    On October 22, 2018, the Trump administration released new guidance on Section 1332 waivers established by the Affordable Care Act (ACA). The new guidance may encourage states to use 1332 waiver authority to make broader changes to insurance coverage for their residents, including to promote the sale of, and apply subsidies to, ACA non-compliant policies. On November 29, 2018, the Centers for Medicare and Medicaid Services (CMS) released a discussion paper outlining a set of…