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Five Things to Know about the Renewal of Extra Affordable Care Act Subsidies in the Inflation Reduction Act

As part of the Inflation Reduction Act, the Senate recently passed a three-year extension (through 2025) of enhanced subsidies for people buying their own health coverage on the Affordable Care Act Marketplaces. The enhanced subsidies increase the amount of financial help available to those already eligible and also newly expand subsidies to middle-income people, many of whom were previously priced out of coverage. Here’s what to know about the likely renewal of these subsidies:

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An Early Look at What is Driving Health Costs in 2023 ACA Markets

This analysis of marketplace insurers’ early rate filings in 13 states and the District of Columbia finds that they are seeking higher premium increases than in recent years, largely due to rising prices paid to hospitals, doctors and drug companies and increased use of services by enrollees.

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Marketplace Insurers Denied Nearly 1 in 5 In-Network Claims in 2020, though It’s Often Not Clear Why

Healthcare.gov marketplace insurers denied nearly one out of every five claims (18%) submitted for in-network services in 2020, though why the denial rates are so high and the ultimate consequences for consumers are difficult to access from the publicly available data, a new KFF analysis finds. The Affordable Care Act…

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Claims Denials and Appeals in ACA Marketplace Plans in 2020

This analysis of transparency data released by the Centers for Medicare and Medicaid Services (CMS) finds that 18% of in-network claims were denied by healthcare.gov marketplace insurers in 2020, with denial rates varying widely from less than 1% to more than 80%. Consumers appealed just over one-tenth of 1% of those denied claims.

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The Uncertain Future of Policies to Promote Access and Affordability Put in Place During the COVID-19 Pandemic

In this column for the JAMA Health Forum, Larry Levitt highlights four changes implemented during the COVID-19 pandemic that helped to make health care more accessible and affordable and the prospects for those changes to telehealth, COVID-19 coverage, Medicaid and marketplace premiums continuing beyond the pandemic’s end.

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For ACA Enrollees, How Much Premiums Rise Next Year is Mostly up to Congress

Most customers with coverage through Affordable Care Act’s marketplaces will face big premium increases next year if Congress doesn’t extend the temporary enhanced tax credits included in the American Rescue Plan Act (ARPA) of 2021. If the outcome isn’t clear by summer, fall open enrollment could be a mess.

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Many Workers, Particularly at Small Firms, Face High Premiums to Enroll in Family Coverage, Leaving Many in the ‘Family Glitch’

Data from the KFF Employer Health Benefits Survey demonstrates that some workers face very high contribution amounts for family coverage, including 12% who would have pay at least $10,000 annually in premiums for a family of four. These are the workers most likely to benefit from a fix to the ‘family glitch’.

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Without Build Back Better, Will the End of the Public Health Emergency Leave Even More People Uninsured?

Continuous enrollment in Medicaid and enhanced premium assistance have helped millions afford and maintain coverage, but those gains could be reversed as the public emergency ends and if the provisions like those in the Build Back Better Act fail to pass.

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Network Adequacy Standards and Enforcement

Health plan networks affect patient access to care. This brief reviews options for setting and enforcing network adequacy standards and tools for making differences in plan networks more transparent.

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Build Back Better Would Change the Ways Low-Income People get Health Insurance

The Build Back Better Act would make a number of changes to the way people get health insurance and how health care is financed, including by temporarily closing the Medicaid coverage gap.

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California.