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  • Analysis: 6.3 Million People with Pre-Existing Conditions Would Be at Risk for Higher Premiums under the House’s Health Bill

    News Release

    A new Kaiser Family Foundation analysis estimates that 6.3 million people -- 23 percent of 27.4 million non-elderly adults with a gap of several months in insurance coverage in 2015 – could potentially face higher premiums under the House’s American Health Care Act (AHCA), due to pre-existing health conditions. The bill, which passed the House earlier this month, allows states to waive community rating in the individual insurance market. Insurers in states with such waivers…

  • Gaps in Coverage Among People With Pre-Existing Conditions

    Issue Brief

    The American Health Care Act (AHCA), which has passed the House of Representatives, contains a controversial provision that would allow states to waive community rating in the individual insurance market. In this brief we estimate the number of people with pre-existing conditions who might be affected by such a policy.

  • 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…

  • Turning the Spotlight on Medicare Advantage for 2017

    News Release

    Medicare Advantage plans, which consist primarily of HMOs and PPOs, now cover almost 18 million people – nearly one-third of all Medicare beneficiaries.  Medicare Advantage plans have been in the news lately because the proposed merger between Aetna and Humana, which together account for one-quarter of all Medicare Advantage enrollees, could further consolidate the Medicare Advantage market. A Kaiser Family Foundation analysis, featuring the latest publicly available data on the 2017 Medicare marketplace, examines new…

  • Medicare Advantage Plans in 2017: Short-term Outlook is Stable

    Issue Brief

    This issue brief analyzes the number and variety of Medicare Advantage plan choices available to beneficiaries in 2017. It describes trends in number of Medicare Advantage plans and plan quality ratings, and new information on plan premiums, out-of-pocket expense limits, and other plan features. This spotlight is part of a series of spotlights tracking key changes in the Medicare Advantage program.

  • Medicare Part D: A First Look at Prescription Drug Plans in 2017

    Issue Brief

    This issue brief provides an overview of the 2017 Medicare Part D stand-alone prescription drug plan marketplace, based on analysis of data from the Centers for Medicare & Medicaid Services. The brief focuses on data for 2017 and changes over time in plan availability, premiums, benefit design, cost sharing, and low-income subsidy plan availability.

  • CMS’s Denial of Proposed Changes to Medicaid Expansion in Ohio

    Fact Sheet

    This fact sheet discusses CMS's denial of Ohio's proposed changes to its existing Medicaid expansion . It also provides an overview of the proposed changes as included in the state's Section 1115 demonstration waiver application.