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  • Competition Has Increased in the Individual Market in Recent Years but Fallen in Fully Insured Group Markets

    Recent Trends in Commercial Health Insurance Market Concentration

    Issue Brief

    Commercial health insurance markets remain highly concentrated across coverage types. However, the individual market, which consists mostly of the ACA Marketplaces, has attracted more insurers and witnessed greater insurer competition across a variety of measures since the implementation of the enhanced premium tax credits in 2021, according to a new Healthy System Tracker analysis.

  • 2024 Medical Loss Ratio Rebates

    Issue Brief

    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.

  • 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…

  • 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…

  • News Release

    Private Insurers Expect to Pay $1.1 Billion in Rebates This Year for Setting Premiums Too High Relative to Medical Costs

    News Release

    Private insurance companies are expecting to pay out about $1.1 billion in rebates this fall under an Affordable Care Act (ACA) 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 estimated total is similar to the $1 billion paid out last year, but well short of the $2.5 billion record total paid…

  • 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…