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Claims Denials and Appeals in ACA Marketplace Plans in 2024
Issue BriefThis brief analyzes federal transparency data published by CMS on claims denials and appeals for Marketplace plan offered on HealthCare.gov in 2024, and finds insurers denied 19% of in-network claims. Consumers rarely appeal denied claims.
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Explaining Individual Coverage Health Reimbursement Arrangements (ICHRAs)
Issue BriefThis policy explainer describes what Individual Coverage Health Reimbursement Arrangements (ICHRAs) are and how do they differ from typical employer-sponsored health care plans.
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8 Things to Watch for the 2026 ACA Open Enrollment Period
Issue BriefThe ACA Marketplace Open Enrollment season begins November 1, and with it comes looming changes to the enhanced premium tax credits, increases in out-of-pocket premium payments, new Marketplace eligibility rules, and more. Read our analysis of what these and other changes could mean for new and returning enrollees.
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New Analysis Finds US Individual Insurance Market Grew 46 Percent in First Full Year of Affordable Care Act
News ReleaseA new analysis from the Kaiser Family Foundation finds that the nation's individual insurance market grew 46 percent to 15.5 million people in the first year plans could be purchased through the Affordable Care Act's marketplaces, which offer premium assistance to low- and moderate-income people. Four states -- California, Florida, Texas and Georgia -- accounted for almost half of the enrollment growth. In six states, the number of people covered in the individual market increased…
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Updated FAQs Provide New Answers as the Affordable Care Act’s Marketplace Enters Its Second Year
News ReleaseToday, the Kaiser Family Foundation released an updated collection of Frequently Asked Questions (FAQs) providing detailed answers for consumers, and the navigators and brokers who assist them, as the Nov. 15 start date nears for the Affordable Care Act's second open enrollment period. The searchable collection includes nearly 300 up-to-date responses, answering new questions about plan renewal, cancellations, and continuing financial assistance. The FAQs also offer guidance for understanding 2014 federal income taxes in the…
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Potential Savings from Actively Shopping for Marketplace Coverage in 2016
Issue BriefThis analysis looks at how the premiums for the lowest-cost silver plans in Affordable Care Act (ACA) Marketplaces changed between 2015 and 2016. The analysis examines premiums of the 2015 lowest-cost silver plans (in states that used Healthcare.gov in both 2015 and 2016) for a single 40 year-old adult to see how much these premiums increase in 2016 and whether enrollees could obtain lower premiums by switching plans.
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Updated for 2015: Tool Displays By Locality the Share of Potential ACA Federal Marketplace Enrollees That Signed Up
News ReleaseAn interactive tool from the Kaiser Family Foundation is now updated with 2015 data, allowing users to view on a local level the share of potential enrollees who signed up for a health plan in a federally-based marketplace under the Affordable Care Act. With Mapping Marketplace Enrollment, users can also compare the number of potential and actual enrollees – and the percentage that signed up for a plan -- in 2014 and 2015 within 100,000-resident…
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Visualizing Health Policy: Premium Changes in the Affordable Care Act’s Insurance Marketplaces 2014-2015
Other PostThis Visualizing Health Policy infographic with the Journal of the American Medical Association (JAMA) illustrates the change in monthly premiums by county, and select cities, from 2014 to 2015 for a 40-year-old person covered by the second-lowest-cost silver "benchmark" plan in the Affordable Care Act's insurance marketplaces.
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Visualizing Health Policy: Premium Changes in the Affordable Care Act’s Insurance Marketplaces 2014-2015
News ReleaseThis Visualizing Health Policy infographic illustrates the change in monthly premiums by county, and select cities, from 2014 to 2015 for a 40-year-old person covered by the second-lowest-cost silver “benchmark” plan in the Affordable Care Act’s insurance marketplaces. Premium changes were greatest in Summit County, Colo. (45% decrease) and southeastern Alaska (34% increase), before tax credits. After accounting for tax credits, premiums for a 40-year-old person with an annual income of $30,000 would remain flat in…