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Falling off the Subsidy Cliff: How ACA Premiums Would Change for People Losing Rescue Plan Subsidies
This post examines what would happen to ACA marketplace premiums for enrollees with incomes more than four times the federal policy level if the enhanced American Rescue Plan Act subsidies expire, including variations by state .
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Demographics and Health Insurance Coverage of Nonelderly Adults With Mental Illness and Substance Use Disorders in 2020
In this issue brief, we use 2020 data from the National Survey on Drug Use and Health (NSDUH) to examine key characteristics, coverage and health status of nonelderly adults with mental illness or substance use disorders to help inform ongoing federal and state efforts to improve quality and expand access.
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Data Note: 2022 Medical Loss Ratio Rebates
We find that insurers estimate they will issue a total of about $1 billion in Medical Loss Ratio (MLR) rebates this year across all commercial markets under a provision of the Affordable Care Act (ACA) that limits the share of premiums that insurers can keep for administration, marketing, and profits.
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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
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…
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Examining Prior Authorization in Health Insurance
This post explains what’s known about how insurers use prior authorization as a tool to control costs and encourage cost-effective care, the state and federal laws that govern it, and ongoing policy debates over efforts to impose standards to limit or regulate its use.
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The Uncertain Future of Policies to Promote Access and Affordability Put in Place During the COVID-19 Pandemic
In this column for the JAMA Health Forum, Larry Levitt highlights four changes implemented during the COVID-19 pandemic that helped to make health care more accessible and affordable and the prospects for those changes to telehealth, COVID-19 coverage, Medicaid and marketplace premiums continuing beyond the pandemic’s end.
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For ACA Enrollees, How Much Premiums Rise Next Year is Mostly up to Congress
Most customers with coverage through Affordable Care Act’s marketplaces will face big premium increases next year if Congress doesn’t extend the temporary enhanced tax credits included in the American Rescue Plan Act (ARPA) of 2021. If the outcome isn’t clear by summer, fall open enrollment could be a mess.
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Employer Coverage of Travel Costs for Out-of-State Abortion
This Policy Watch gives an overview of employers offering to cover travel expenses for workers who need to go out of state for an abortion in the context of increasing restrictions on abortion around the country. We discuss who is offering these benefits, the implications for workers, and some of the legal and political concerns for employers.
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Analysis: The Vast Majority of Physicians Accept New Patients, Including Patients With Medicare and Private Insurance
Despite occasional anecdotal reports of people having trouble finding a doctor who takes their insurance, KFF researchers find in a new analysis that the vast majority of non-pediatric office-based physicians accept new Medicare patients, as well as new private insurance patients. Eighty-nine percent of such physicians accepted new Medicare patients…
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Most Office-Based Physicians Accept New Patients, Including Patients With Medicare and Private Insurance
This brief examines the share of non-pediatric office-based physicians accepting new patients with Medicare or private insurance and how these rates have changed over time and vary by physician specialties, geographic areas, and physician and practice characteristics across Medicare and private insurance. This analysis further examines the extent to which non-pediatric physicians are opting out of Medicare, by specialty and state.
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