Individual Market - Research and Data from KFF

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

Aug 5, 2019

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.

Data Note: Changes in Enrollment in the Individual Health Insurance Market through Early 2019

Aug 21, 2019

Issue Brief

This analysis measures changes in enrollment in the individual market, including those in both marketplace plans and off-exchange plans, before and after the ACA’s coverage expansions and market rules went into effect in 2014 through the first quarter of 2019.

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

Sep 10, 2019

News Release

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 KFF analysis.

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

Oct 4, 2019

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…

What to Look for in 2017 ACA Marketplace Premium Changes

May 5, 2016

Perspective

This brief discusses the key factors that will influence the rate changes that insurers are requesting in 2017 Affordable Care Act (ACA) Marketplaces, including current premiums, forecasted enrollment changes, increases in price and use of services, changes in policy design or network, changes in law or regulation, and competition.

5 things to know about Obamacare’s (likely) premium hikes

May 11, 2016

Perspective

In this guest column for VOX, the Kaiser Family Foundation's Larry Levitt examines several key factors behind the expected premium rate increases for the Affordable Care Act's marketplace plans in 2017 and what they mean for the stability of the marketplace.

Aprenda sobre seguros médicos: los videos en español

May 11, 2016

Video

The YouToons help consumers understand health insurance by explaining health insurance premiums, out-of-pocket costs, and provider networks. These three videos are excerpts from the 2014 YouToons video, Health Insurance Explained – The YouToons Have It Covered.

Following Some Withdrawals, More Counties Could Have One ACA Marketplace Insurer in 2017

May 16, 2016

Feature

Counties with 1 exchange insurer Download Source Kaiser Family Foundation analysis of data from Healthcare.gov; state-based exchange enrollment websites and rate filings; and news reports of market entrants and exits.

New Rules for Section 1332 Waivers: Changes and Implications

Dec 10, 2018

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 waiver concepts designed to provide states with a roadmap for developing waiver applications that use the flexibility granted under the new guidance. This issue brief describes the new guidance, highlighting key changes from the 2015 guidance, describes how state waiver activity may change, particularly in light of the waiver concepts put forward by CMS, and discusses possible implications of the changes.

36 States Saw Uninsured Rate Increase in 2017, Including Some that Expanded Medicaid

Dec 14, 2018

Feature

The uninsured rate increased in 36 states in 2017, including some that expanded Medicaid. In KFF's Chart of the Week, explore the uninsured rate increases and decreases for all 50 states.

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