Private Insurance

KFF’s Karen Pollitz testimony before the U.S. House Committee on Ways and Means on Jan. 29, 2019 examines the prevalence of pre-existing conditions, the impact of the Affordable Care Act’s prohibition against medical underwriting and other provisions aimed at stabilizing the insurance risk pool, and the trade-offs involved in relaxing those provisions. 

Healthcare.gov marketplace insurers denied nearly one out of every five claims (19%) submitted for in-network services in 2017, and enrollees only appeal a tiny share (0.5%) of those denied claims, a KFF analysis of recently released claims data finds. The analysis finds a huge variation across insurers, with average denial…

In this Axios column, Drew Altman shows that employer coverage for lower wage workers is much worse than ACA marketplace coverage for similar populations. It’s a bigger problem we need to talk about more, he says.

This analysis looks at the share of working families’ income that is spent on premiums, deductibles and other cost-sharing for employer-sponsored care. It shows that lower-income families spend a greater share of their income on health costs than those with higher incomes.

The April 2019 KFF Health Tracking Poll examines the public’s position on the future of ACA and its protections for people with pre-existing medical conditions, in light of the ongoing legal battle which may end up in the Supreme Court. With lawmakers proposing legislation to address surprise medical bills, this month’s survey also measures the public’s support for federal government action to protect patients from having to pay the cost incurred from an inadvertent out-of-network provider.

Individual market insurers are expecting to return to consumers a record total of about $800 million in medical loss ratio rebates for 2018, a year in which the insurance companies posted their best annual financial performance under the Affordable Care Act to date. Financial results for 2018 suggest that insurers in the individual market are generally returning to or exceeding profitability levels seen before 2014, when ACA insurance market rules took effect, including the requirement to cover people with pre-existing conditions.

In this Axios column, Drew Altman shows that employer coverage for lower wage workers is much worse than ACA marketplace coverage for similar populations. It’s a bigger problem we need to talk about more, he says.

Individual market insurers are expecting to return to consumers a record total of about $800 million in excess premiums for 2018, a year in which the insurance companies posted their best annual financial performance under the Affordable Care Act to date, finds a new KFF analysis. The rebates to more…

In this May 2019 post for The JAMA forum, Larry Levitt examines how the early discussion and positioning among the presidential candidates offers a glimpse into how a debate about Medicare-for-all might play out.

KFF’s Tricia Neuman’s testimony before the U.S. House Committee on Ways and Means on June 12, 2019 describes a range of proposals to broaden health insurance coverage and make health care more affordable, the similarities and differences among them, and the policy choices and trade-offs that could have significant implications for coverage and costs.