Filling the need for trusted information on national health issues
One of the first provisions that would be implemented under federal health reform bills in the House and the Senate would establish a national high-risk pool program to offer coverage to otherwise uninsurable individuals during the interim period between enactment and implementation of broader health care reforms. High-risk pools provide…
This policy brief provides data and analysis of coverage and access to oral health care for low-income nonelderly adults. Lack of resources to pay for dental services, either through dental insurance or out-of-pocket, is a major barrier to oral health care for many low-income Americans. The problem is particularly acute…
To broaden coverage, some health reform proposals would require employers to offer coverage or pay to help finance subsidies for those without access to affordable coverage. These types of reforms are often referred to as “pay-or-play” policies. The brief explains the concept and policy implications of employer pay-or-play proposals, which…
This report from the Kaiser Family Foundation analyzes the effect of government efforts to ensure that insurance premium increases are justifiable and provide value to consumers and small businesses. Rate review programs require insurers in the small group and individual markets to submit proposed rate increase requests to state or…
This issue brief explains key elements of the Congressional Budget Office’s estimates of the major health reform bills pending in Congress, the Affordable Health Care for America Act (H.R. 3962) and the Patient Protection and Affordable Care Act (H.R. 3590). Throughout the health reform debate, CBO has analyzed these and…
The health reform legislation currently being crafted on Capitol Hill is undeniably complex. To oversimplify slightly it can be boiled down into four parts: coverage (subsidies for private coverage and Medicaid expansions); delivery and payment reforms; insurance market reforms and regulations; and prevention, with each broad category containing a range…
The Affordable Care Act creates a process for states and the Department of Health and Human Services to review “unreasonable” premium increases and provide information to consumers about the process. The rules governing this rate review process went into effect September 1, 2011. This briefing by the Kaiser Family Foundation,…
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…
This policy paper describes key requirements of consumer protection regulation under Medicare, Medicaid and federal and state laws as they apply to private health insurance. These include choice and availability of plans, disclosure of information, marketing, access, quality, and the grievance and appeals process. The discussion highlights differences and similarities…
This report provides information about the individual health insurance market using data from the largest vendor of this type of insurance, eHealthInsurance. The report includes who is buying individual insurance, what they are actually paying for the insurance, and buying patterns. It is the first in an up-coming series of…
