Medicaid/CHIP Coverage of Lawfully-Residing Immigrant Children and Pregnant Women March 16, 2023 State Indicator immigrant children pregnant women Medicaid CHIP
Medicaid Income Eligibility Limits for Adults as a Percent of the Federal Poverty Level March 16, 2023 State Indicator eligibility Medicaid Adults
Medicaid and CHIP Income Eligibility Limits for Pregnant Women as a Percent of the Federal Poverty Level March 16, 2023 State Indicator eligibility Medicaid CHIP
Medicaid and CHIP Income Eligibility Limits for Children as a Percent of the Federal Poverty Level March 16, 2023 State Indicator eligibility children Medicaid CHIP
Medicare Advantage Insurers Report Much Higher Gross Margins Per Enrollee Than Insurers in Other Markets February 28, 2023 News Release A new analysis of health insurers’ 2021 financial data shows that insurers continue to report much higher gross margins per enrollee in the Medicare Advantage market than in other health insurance markets. The analysis examines insurers’ financial data in the Medicare Advantage, Medicaid managed care, individual (non-group), and fully insured…
Health Insurer Financial Performance in 2021 February 28, 2023 Issue Brief Using health insurer financial data for 2021, we find that Medicare Advantage insurers reported gross margins that were at least twice as high as those reported by insurers in the individual/non-group, fully-insured group/employer, and Medicaid managed care markets. The four markets report similar simple medical-loss-ratios.
Many Women Use Preventive Services, but Gaps in Awareness of Insurance Coverage Requirements Persist: Findings from the 2022 KFF Women’s Health Survey February 22, 2023 Issue Brief This brief presents findings from the 2022 KFF Women’s Health Survey on women’s receipt of cancer screenings and other preventive services and differences between subgroups of women. We also present data on women’s and men’s awareness of federal requirements for private insurance coverage of preventive services.
CMS Prior Authorization Proposal Aims to Streamline the Process and Improve Transparency February 21, 2023 Issue Brief This brief explains a new proposed federal regulation aimed at reducing administrative hassles involved in obtaining prior authorization for care and sets out key policy questions, including how the proposal could impact the patient experience and data privacy.
Claims Denials and Appeals in ACA Marketplace Plans in 2021 February 9, 2023 Issue Brief This analysis of HealthCare.gov Marketplace insurers’ transparency data finds that 17% of in-network claims were denied in 2021, with denial rates varying widely across insurers. Consumers appealed less than two-tenths of 1% of denied in-network claims.