Tariffs Are Driving up Premiums for Small Businesses
Some insurers in the ACA’s small group market are citing tariffs, particularly those affecting prescriptions drugs, as a reason for higher-than-expected premium increases.
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Health Insurer Financial Performance in 2023
Issue BriefUsing 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.
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2024 Medical Loss Ratio Rebates
Issue BriefInsurers 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.
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KFF Examines Key Considerations for the Implementation of Insurance Coverage for Over-the-Counter Contraceptives
News ReleaseWith 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.
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Considerations for Covering Over-the-Counter Contraception
Policy WatchIn 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 of OTC Oral Contraceptives.
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Private Insurers Expect to Pay $1.1 Billion in Rebates This Year for Setting Premiums Too High Relative to Medical Costs
News ReleasePrivate 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.
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Private Insurers Expect to Pay $1 Billion in Rebates to Consumers This Year for Setting Premiums Too High Relative to Medical Costs
News ReleasePrivate 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.
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Analysis Suggests Health Insurers Remained Profitable Across Markets Amid Pandemic in 2020
News ReleaseA new analysis of health insurers’ financial data suggests that they remained profitable across markets in 2020 due in part to an unprecedented decrease in health spending and utilization in the spring as the COVID-19 pandemic led to massive shutdowns.
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Private Insurers Are Expected to Pay $2.1 Billion in Rebates to Consumers This Year for Excessive Health Insurance Premiums Relative to Health Care Expenses
News ReleasePrivate insurance companies are expecting to pay out $2.1 billion in rebates to consumers this fall, the second highest amount ever issued under the Affordable Care Act, according to a new KFF analysis.