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One of the early insurance market changes in the Affordable Care Act (ACA) phases out caps that some insurance plans impose on the annual dollar amount of benefits they will cover. Plans issued or renewed after September 23, 2010 cannot have annual limits of less than $750,000, and the threshold goes up to $1.25 million in 2011. Annual dollar limits of any kind are prohibited starting in 2014. The federal government has issued waivers from…
The U.S. Department of Health and Human Services (HHS) recently announced significant changes to the premiums charged in the Pre-existing Condition Insurance Plan (PCIP), aka the "high risk pool" created by the Affordable Care Act. Premiums will now be up to 40% lower depending on the state (in some states the cost to enrollees is unchanged), and application procedures will be eased. The PCIP plans provide coverage for people who cannot buy coverage in the…
Recently, the New York Times reported that private health insurers continue to seek large premium increases despite seeing lower than expected use of medical care and booking record profits. The story highlights a significant problem for health policy: the lack of good, public information about how health insurers manage health care use and what they pay for medical services. As a nation, we rely on competition among largely private health plans to ensure that health…
There's been quite a bit of focus lately insofar as these issues go, anyway on health insurance agents and brokers (sometimes known in the industry as "producers"). They are pushing legislation that has been introduced in Congress and is now being studied by the National Association of Insurance Commissioners that would exempt agent and broker commissions for health insurance from minimum medical loss ratio (MLR) thresholds established in the health reform law. (The MLR is…
About One In Four Covered Workers Now Face Annual Deductibles Of $1,000 Or More, Including Nearly Half Of Those Employed By Small Businesses WASHINGTON, D.C. -- Workers on average are paying nearly $4,000 this year toward the cost of family health coverage - an increase of 14 percent, or $482, above what they paid last year, according to the benchmark 2010 Employer Health Benefits Survey released today by the Kaiser Family Foundation and the Health…
Facing Such Increases, Some Enrollees Switched To Lower-Cost Coverage People With Pre-Existing Conditions Much More Likely To Report Problems MENLO PARK, CA -- People who buy their own insurance report that their insurers most recently requested premium increases averaging 20 percent, according to a new Kaiser survey examining the experiences and views of people who buy health coverage in the non-group or individual market. Overall roughly three in four people (77 percent) with non-group coverage…
People who buy their own insurance report that their insurers most recently requested premium increases averaging 20 percent, according to a new Kaiser survey examining the experiences and views of people who buy health coverage in the non-group or individual market. Overall roughly three in four people (77 percent) with non-group coverage report facing a premium increase with a current or previous insurer. Most say they paid the increase, but 16 percent of all policyholders…
While most people in the U.S. get health insurance through their employer, about 14 million people under age 65 have coverage through the non-group or individual market, which has faced scrutiny recently in news reports about some insurers’ steep rate increases and in the market reforms in the new health reform law that will take effect in 2014. This survey provides insight into the current state of the non-group market and finds policyholders report that…
The Alliance for Health Reform and The Commonwealth Fund co-sponsored this briefing to explore the health reform proposals being considered which may impose responsibilities on both individuals and employers to have and help pay for coverage and whether they will be able to pay the amounts above the subsidies. Questions addressed include:If Congress exempts people from the coverage requirement or significantly reduces the penalties for noncompliance, will enough healthy individuals purchase new coverage to adequately…
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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