The independent source for health policy research, polling, and news.
KFF’s policy research provides facts and analysis on a wide range of policy issues and public programs.
KFF designs, conducts and analyzes original public opinion and survey research on Americans’ attitudes, knowledge, and experiences with the health care system to help amplify the public’s voice in major national debates.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the organization’s core operating programs.
Using health insurer financial data for 2023, we find that in 2023, per enrollee gross margins were highest in the Medicare Advantage market, and medical loss ratios were lowest in the individual insurance market. Across most markets, gross margins have been relatively stable in recent years.
Insurers estimate they will pay $1.1 billion in Medical Loss Ratio (MLR) rebates in 2024 to select individuals and employers that purchase their health coverage, according to a KFF analysis of preliminary data reported to state regulators. The estimated rebate for 2024 is larger than rebates issued in most prior years. Nearly $12 billion in rebates have been issued since 2012.
A provision in the Senate Better Care Reconciliation Act (BCRA), a bill to repeal and replace the Affordable Care Act (ACA), would establish association health plan options for small employers and self-employed individuals. For these plans, the requirement that premiums cannot vary based on health status would not apply. This brief describes how association health plans could affect premiums in the small group and non-group markets.
There has been a substantial amount of focus on the recently released draft regulations governing state-based health insurance exchanges under the Affordable Care Act (ACA). And that's appropriate, since the exchanges have the important roles under reform of providing consumers with easier access to insurance and facilitating tax credits and cost-sharing subsidies that make coverage more affordable.
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").
Surprisingly, in comparison to the nearly 9% drop in employment from March to June, early data suggests that employers had kept coverage rates remarkably steady, at least through mid-summer. We find that enrollment in the fully-insured group market dropped by just 1.3% from the end of March through the end of June.
This fact sheet explains the Medical Loss Ratio requirement under the Affordable Care Act (ACA). The MLR provision limits the portion of premium dollars health insurers may spend on administration, marketing, and profits. Under health care reform, health insurers must publicly report the portion of premium dollars spent on health care and quality improvement and other activities in each state they operate. Insurers failing to meet the applicable standard must pay rebates to consumers and businesses.
preex by market pre post aca Download Source Kaiser Family Foundation…
© 2025 KFF