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Medigap: Spotlight on Enrollment, Premiums and Recent Trends

Medicare supplemental insurance, also known as “Medigap,” is an important source of supplemental coverage for nearly one in four people on Medicare. Traditional Medicare has cost-sharing requirements and significant gaps in coverage; Medigap helps make health care costs more predictable and stable for beneficiaries by covering some or all Medicare…

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Explaining Health Care Reform: Risk Adjustment, Reinsurance, and Risk Corridors

This brief explains three provisions of the Affordable Care Act (ACA) – risk adjustment, reinsurance, and risk corridors – that were intended to promote insurer competition on the basis of quality and value and promote insurance market stability, particularly in the early years of reform as the ACA marketplaces, also known as exchanges, were established.

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Sizing Up Exchange Market Competition

This issue brief offers an early look into how competitive the health insurance exchanges (also called marketplaces) are under the Affordable Care Act in selected states. Through analysis of enrollment data released by seven states (California, Connecticut, Minnesota, New York, Nevada, Rhode Island, and Washington) this brief finds that exchange markets in California and New York are shaping up to be more competitive than their individual markets were in 2012 while those of Connecticut and Washington show less competition (less even market share distribution). In several states, market concentration of individual insurers have shifted significantly compared to the individual market prior to the ACA, pointing to the potential for greater price competition in the future and the influence of new entrants to the market.

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Medicare’s Income-Related Premiums Under Current Law and Proposed Changes

Most people with Medicare pay the standard monthly premium for Part B and Part D coverage, which is set to cover 25 percent of Part B and Part D program costs, but a relatively small share of beneficiaries are required to pay higher premiums. This issue brief describes current requirements with respect to Medicare’s Part B and Part D income-related premiums and proposed changes under House legislation being considered in November 2017.

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How do Premiums and Cost Sharing Affect Low-Income People in Medicaid?

A new issue brief from the Kaiser Family Foundation reviews what the research shows about the effects of premiums and cost sharing on low-income populations in Medicaid and the Children’s Health Insurance Program (CHIP), drawing upon 65 peer-reviewed studies and government and research and policy organization reports and studies published…

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Revisiting ‘Skin in the Game’ Among Medicare Beneficiaries: An Updated Analysis of the Increasing Financial Burden of Health Care Spending From 1997 to 2005

This issue brief presents an analysis of the financial burden of out-of-pocket health care spending for Medicare beneficiaries between 1997 and 2005. The analysis shows median out-of-pocket spending as a share of Medicare beneficiaries’ income increased between 1997 and 2005, from 11.9 percent to 16.1 percent. For some beneficiaries, the spending burden was even greater, with 25 percent of people on Medicare spending nearly one-third or more of their income on health care.

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Premiums under the Senate Better Care Reconciliation Act

This analysis provides estimates of how premiums, after taking into account tax credits, would differ in 2020 under the Senate’s Better Care Reconciliation Act (BCRA) vs. the Affordable Care Act (ACA) for people currently enrolled in the federal and state insurance marketplaces.

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How the Senate Better Care Reconciliation Act (BCRA) Could Affect Coverage and Premiums for Older Adults

This brief explains the key provisions of the Senate’s Better Care Reconciliation Act (BCRA), and their effects on adults ages 50-64. The brief also discusses how changes to Medicaid could affect older, low-income adults, and how an increase in the number of uninsured older adults could have implications for the Medicare program in the future.

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How Many of the Uninsured Can Purchase a Marketplace Plan for Less Than Their Shared Responsibility Penalty?

For people who are uninsured and eligible for Affordable Care Act (ACA) marketplace plans, the analysis compares the cost of a premium for the lowest-cost bronze plan with the estimated individual mandate tax penalty for 2018. It finds that more than half (54% or 5.9 million) of the 10.7 million people could pay less in premiums for health insurance than they would owe as an individual mandate tax penalty for lacking coverage.

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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.