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  • Considerations for Covering Over-the-Counter Contraception

    Policy Watch

    In October 2023, the Departments of the Treasury, Labor, and Health and Human Services issued a request for information to gather public input about the potential benefits, costs, and implementation considerations of requiring private health insurance plans to cover OTC preventive services and supplies without a prescription. This policy watch addresses key considerations for the implementation of insurance coverage for non-prescribed OTC contraceptives based on the lessons learned from KFF’s 2023 study of Insurance Coverage…

  • Health Insurance Market Reforms: Guaranteed Issue

    Fact Sheet

    Guaranteed issue laws require insurance companies to issue a health plan to any applicant - an individual or a group - regardless of the applicant's health status or other factors. Currently, in most states, insurance companies can deny nongroup coverage to people based on their health status or their medical expenses over the past year. This means that an uninsured person who develops a certain condition, such as breast cancer, might not be able to…

  • Private Insurers Expect to Pay $1 Billion in Rebates to Consumers This Year for Setting Premiums Too High Relative to Medical Costs

    News Release

    Private insurance companies are expecting to pay out $1 billion in rebates to consumers this fall under an Affordable Care Act provision that requires insurers to spend the bulk of customers’ premium payments on care, a new KFF analysis finds. Rebates are based on insurers’ experiences over the previous three years. This year’s total is roughly half the size of last year’s $2 billion, in part because 2021 was a less profitable year and because…

  • KFF Examines Key Considerations for the Implementation of Insurance Coverage for Over-the-Counter Contraceptives

    News Release

    With federal regulators seeking public input on the potential benefits, costs, and implementation considerations of requiring private health insurance plans to cover over-the-counter preventive products without a prescription, a new KFF post explores the issues relevant to covering over-the-counter contraceptives. These contraceptives include Opill, the first daily oral contraceptive pill to receive FDA approval for over-the-counter availability. The analysis draws on the lessons learned from KFF staff interviews with more than 80 key players nationally…

  • Survey of Health Insurance Agents: Assessing Trends in the Individual and Small Group Insurance Markets

    Poll Finding

    This nationally representative survey of 500 health insurance agents and brokers working in the individual and small group markets explores their outlook on market trends and views on the Affordable Care Act (ACA). The survey finds that many agents are seeing steep increases in premiums and deductibles for individuals and small businesses purchasing health insurance. When asked to estimate what they expect to be the typical premium increase in 2012 based on what they have…

  • Health Insurer Financial Performance Through September 2020

    Issue Brief

    In this brief, we analyze third quarter data from 2018 to 2020 to examine how insurance markets performed financially through the end of September. Average margins remained relatively high compared to the same point in recent years, suggesting many insurers remained profitable even as non-COVID-related care returned in the summer and fall.