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TrumpRx: What’s the Value for Customers?

In February, the Trump administration launched TrumpRx, a government website that provides prescription drug discounts to consumers. This brief examines issues that may impact consumers, especially those with private insurance, who access drug discounts through TrumpRx.

Claims Denials and Appeals in ACA Marketplace Plans in 2024

This brief analyzes federal transparency data published by CMS on claims denials and appeals for Marketplace plan offered on HealthCare.gov in 2024, and finds insurers denied 19% of in-network claims. Consumers rarely appeal denied claims.

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  • Comparisons of the Liability Provisions of the House and Senate Patients’ Rights Bills

    Report

    A hotly debated issue in Congress has been the issue of when health maintenance organizations, health insurers, and those who administer health benefit plans should be financially liable to their plan participants for a denial of a claim or for damages for any injuries that result from such denials (known as health plan liability ). This new report by Gary Claxton of the Georgetown Institute for Health Care Research and Policy describes the health plan…

  • How Private Insurance Works: A Primer

    Report

    This primer, prepared by Gary Claxton of the Institute for Health Care Research and Policy at Georgetown University, examines the structure and operation of private health insurance including the types of organizations that provide it, how managed care is delivered, and how risk pools work and describes how private health insurance coverage is regulated under state and federal laws. The primer explains how the current nature of private insurance relates to key issues facing federal…

  • Pieces of the Puzzle

    Report

    A new report describes the Report to Congress by the Department of Health and Human Services on consumer protection and quality assurance requirements for Medicaid managed care and discusses the differences between the original Federal rule and the revised one. Report Executive Summary  

  • New Survey on Consumer Experiences with Health Plans

    Report

    Survey on Consumer Experiences with Health Plans A Kaiser Family Foundation/Harvard School of Public Health survey found that more than six in ten privately insured American adults under age 65 give their health plans a grade of A or B, but nearly half report having some type of problem with their health plan in the last year with a range of consequences for the consumer. The survey found strong support for the right-to-sue a health…

  • Public Opinion Update: The Public, Managed Care, and Consumer Protections

    Fact Sheet

    The Kaiser Family Foundation and Harvard School of Public Health monitored consumer experiences with managed care and attitudes toward alternative consumer protection approaches. This Public Opinion Update summarizes key findings from surveys conducted between 1997 and 2001, a period in which the intensity of public debate and media attention paid to managed care issues varied substantially. Public Opinion Update (PDF)

  • Guide to Federal Patients Bill of Rights Debate

    Report

    This guide, prepared by Stephanie Lewis, JD, MHSA for the Kaiser Family Foundation, explores key issues in the Congressional debate over a federal patients bill of rights.

  • Health News Index – July/August 2001

    Poll Finding

    Health News Index July/August, 2001 The July/August 2001 edition of the Kaiser Family Foundation/Harvard School of Public Health, Health News Index includes questions about major health stories covered in the news, including stem cell research and patients rights legislation. The Health News Index is designed to help the news media and people in the health field gain a better understanding of which health stories Americans are following and what they understand about those health issues.…

  • Employers Attitudes Toward Patients Rights

    Report

    A national survey of employers, released jointly by the Kaiser Family Foundation and the Health Research and Educational Trust, found that smaller employers (3 to 199 employees) are significantly more likely than larger employers (200 or more employers) to support a person's right to sue a health plan, and somewhat more likely to support the right to appeal a health plan's decision to an independent reviewer. Two-thirds (67%) of smaller employers express support for the…

  • Comparison of State Managed Care Liability Laws

    Report

    Since Texas enacted the first law explicitly authorizing suits by enrollees in health plans offered by managed care organizations (MCOs) and other insurers, several other states have adopted similar legislation. This report, prepared by Patricia Butler, J.D., Dr.Ph., for the Kaiser Family Foundation, briefly describes the key features of these state laws, legal challenges that have been raised to some of them, and early experiences in states whose laws are in effect. The key features…

  • Health News Index – May/June 2001

    Poll Finding

    Health News Index May/June, 2001 The May/June 2001 edition of the Health News Index includes questions about major health stories covered in the news, including the Supreme Court ruling regarding the distribution of medical marijuana and the debate in Congress over a Patients Bill of Rights. This edition also includes findings on public support for certain prescription allergy medicines being sold over the counter. The Health News Index is designed to help the news media…