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ACA Open Enrollment: For Consumers Considering Short-Term Policies

A short fact sheet provides information about short-term health insurance policies and how they differ from ACA-compliant plans. 

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ACA Open Enrollment: If You Are Low-Income

This fact sheet explains 2020 health coverage options that may be available to people who have low incomes, including Medicaid coverage or individual insurance plans through Affordable Care Act (ACA) marketplaces.

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ACA Open Enrollment: If You Shop on Private Websites Instead of HealthCare.gov

Marketplace plans can now be sold through private websites, sometimes described as “direct enrollment” sites or “certified enrollment partner” sites. This short fact sheet explains how these sites and the plans they offer may differ from what consumers will find on HealthCare.gov.

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ACA Open Enrollment: If You Buy Health Coverage in the Individual Market

This short explainer provides an overview of open enrollment and the 2020 individual insurance market, including Affordable Care Act (ACA) marketplaces, for consumers who buy their own plans rather than getting insurance through an employer.

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FAQs: Health Insurance Marketplace and the ACA

This list of more than 300 Frequently Asked Questions (FAQs) covers the Affordable Care Act’s health insurance Marketplace (aka exchange), individual mandate, open enrollment, premiums and more. It provides answers to questions about specific groups, such as young adults, smokers, the uninsured, and non-traditional households.

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Coverage for Abortion Services in Medicaid, Marketplace Plans and Private Plans

This brief reviews current federal and state policies on Medicaid and insurance coverage of abortion services and presents national and state estimates on the availability of abortion coverage for women enrolled in private plans, Affordable Care Act Marketplace plans, and Medicaid.

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Ask KFF

Ask KFF: Karen Pollitz Answers 3 Questions on Why Insurers Deny Claims

Karen Pollitz, senior fellow for health reform and private insurance at KFF, answers three questions about denied claims and how the federal government may change the data insurers are required to report on this issue.

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How Affordable are 2019 ACA Premiums for Middle-Income People?

This analysis finds that Affordable Care Act marketplace premiums are least affordable for older adults who earn too much to qualify for federal subsidies, especially those living in rural areas where premiums are highest. The analysis also discusses a variety of state and federal proposals that seek to lower premiums for middle-class people buying their own insurance who are ineligible for ACA subsidies.

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The Henry J. Kaiser Family Foundation

Analysis: Marketplace Plans Denied an Average of Nearly One in Five Claims in 2017 with Wide Variations across Insurers

Healthcare.gov marketplace insurers denied nearly one out of every five claims (19%) submitted for in-network services in 2017, and enrollees only appeal a tiny share (0.5%) of those denied claims, a KFF analysis of recently released claims data finds. The analysis finds a huge variation across insurers, with average denial…

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Claims Denials and Appeals in ACA Marketplace Plans

Based on an analysis of transparency data released by the Centers for Medicare and Medicaid Services (CMS), this brief assess claims denials and appeals among issuers offering individual market coverage on healthcare.gov and finds that 19% of in-network claims were denied by issuers in 2017, with denial rates for specific issuers varying significantly around this average, from less than 1% to more than 40%. Consumers appealed less than 1% of denied claims.

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