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  • Proposals for Insurance Options That Don’t Comply with ACA Rules: Trade-offs In Cost and Regulation

    Issue Brief

    This brief examines four options to promote the sale of health plan options in the individual or non-group market that are not subject to Affordable Care Act (ACA) requirements for other major medical health plans. It reviews the trade-offs involved if such loosely regulated markets take root as an alternative to the ACA-regulated market, particularly as the repeal of the individual mandate penalty takes effect next year.

  • New KFF Resource Tracks Proposed 2019 Marketplace Premiums By State

    News Release

    The Kaiser Family Foundation today launched a tracker to monitor preliminary 2019 premiums in the Affordable Care Act’s marketplaces as insurers file rate information with state regulators. Beginning with data from eight states (Maine, Maryland, New York, Oregon, Rhode Island, Vermont, Virginia and Washington) plus the District of Columbia, the tracker shows preliminary premium information in nine major cities for the lowest-cost bronze plan and “benchmark” silver plan, which is used to determine the size of the…

  • What to Know About Medicare Part D Premiums

    Issue Brief

    Changes to the Medicare Part D benefit in the Inflation Reduction Act will mean lower out-of-pocket costs for Part D enrollees but higher costs for Part D plans overall, leading to concerns about possible premium increases. These FAQs provide context for understanding Part D premiums in 2025 and changes in recent years, and describe actions the Centers for Medicare & Medicaid Services (CMS) is taking to mitigate potential premium increases.

  • Analysis: Insurer Financial Indicators Show Signs of Stabilizing After Transition to ACA Marketplaces

    News Release

    A new Kaiser Family Foundation analysis of key insurer financial indicators suggests that the individual insurance market showed signs of stabilizing in 2016, although profitability remained below the level of performance prior to the opening of the Affordable Care Act’s insurance marketplaces. The new analysis tracks insurer financial performance in the individual market through two key indicators: average medical loss ratios (the share of health premiums paid out as claims) and average gross margins per…

  • Insurers’ Preliminary Rate Filings Anticipate Biggest Increases in ACA Marketplace Plan Premiums Since 2018

    News Release

    This analysis of preliminary rate filings submitted by 105 ACA Marketplace insurers in 19 states and DC shows that ACA Marketplace insurers are requesting a median premium increase of 15% for 2026, which would represent the largest hike in premiums since 2018, the last time policy uncertainty contributed to sharp premium growth. The scheduled expiration of enhanced tax credits and impact of tariffs on some drugs, medical equipment, and supplies are among the factors pushing…

  • Why We Are Stuck with Prior Authorization Review

    From Drew Altman

    Prior authorization review frustrates patients and physicians, but we likely can’t just eliminate it. In his new column, President and CEO Dr. Drew Altman discusses why, and why the focus is now instead on “doing it smarter.” Altman writes: “A proposal to eliminate prior authorization altogether could be the single most tangible and popular health reform idea a candidate could make. But, in our fragmented health system, with no great way to control costs or…

  • Explaining the Muddle on ACA Tax Credits

    From Drew Altman

    In his latest column, KFF’s President and CEO Dr. Drew Altman looks at why the issue of extending the enhanced ACA tax credits has languished in Congress without clear direction, despite its importance to the 24 million people who get their coverage in the ACA Marketplaces today and the potentially significant role the issue could play in the midterms if the credits are not extended.

  • Measuring the Affordability of Employer Health Coverage

    Perspective

    A recent draft regulation issued by the Treasury Department describes who is eligible for premium tax credits to help them afford coverage offered through health insurance exchanges beginning in 2014. Tax credits will be available to people with incomes between 100 and 400 percent of the poverty level who are not eligible for public coverage such as Medicaid or Medicare and who are not offered affordable health coverage by an employer. The approach that the…