Private Insurance

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What Are the Recent Trends in Employer-Based Health Coverage?

Employer-sponsored health insurance is the largest source of health coverage for people under 65. This analysis examines who among people under 65 have employer coverage and which workers are offered and eligible for coverage at their jobs, using the Annual Economic and Social (March) Supplements of the Current Population Survey.

Employer sponsored health insurance

Promotional image for KFF video The True Cost of Employer-Sponsored Health Insurance

Video: What Your Employer-Based Health Coverage Really Costs

More people get health coverage through their job than from any other source. The deduction workers see in each paycheck for their share of the premium is only a fraction of the total cost. In this video, KFF’s Matt Rae unpacks the full cost of employer-sponsored insurance and why it may be the biggest health care affordability story hiding in plain sight.

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  • ACA’s Maximum Out-of-Pocket Limit Is Growing Faster Than Wages

    Issue Brief

    This analysis finds that the ACA’s maximum out-of-pocket limit is likely to grow faster than wages and salaries, and is also expected to grow faster than the maximum out-of-pocket limit for Health Savings Account (HSA)-qualified health plans.

  • How Much and Why ACA Marketplace Premiums Are Going Up in 2025

    Issue Brief

    This analysis of insurers' preliminary rate filings shows that ACA Marketplace insurers are requesting a median premium increase of 7% for 2025, similar to the 6% premium increase filed for 2024. Insurers cite growing health care prices – particularly for hospital care – as a key driver of premium growth in 2025.

  • Insurance Coverage of OTC Oral Contraceptives: Lessons from the Field

    Report

    This report is based on 35 structured interviews conducted from January to August 2023, with nearly 80 experts and key players such as pharmacists, health plans, and state Medicaid officials involved in the coverage and provision of OTC contraception in seven states with one or more of these coverage approaches (IL, NJ, NM, NY, OR, UT, and WA). It discusses the challenges and successes in coverage under private health insurance and Medicaid and reviews policy…

  • As ACA Marketplace Enrollment Reaches Record High, Fewer Are Buying Individual Market Coverage Elsewhere

    Issue Brief

    This analysis looks at how many people are signed up for each type of individual ACA Marketplace coverage—both on- and off-Marketplace and with or without subsidies—as of early 2023 based on federal enrollment data and administrative data insurers report to state regulators, as compiled by Mark Farrah Associates. The number of people enrolled in compliant and non-compliant plans was also evaluated.

  • New KFF Analysis Examines Rapidly Evolving Federal Policies For Substance Use Disorder Treatment for the Opioid Epidemic  

    News Release

    A new KFF analysis finds that 24 percent more buprenorphine, a medication to treat opioid use disorder, was dispensed in 2022 than in 2019, the year before the pandemic brought a surge of opioid overdose deaths – and a focus on how to expand access and treatment. This upward trend in buprenorphine distribution, already in motion before the pandemic, continued throughout the COVID public health crisis, suggesting continued improvements in access to treatment even as…

  • What to Watch in the 2024 ACA Open Enrollment

    Policy Watch

    With the start of the 2024 Affordable Care Act open enrollment, the Marketplaces have been operating for a full decade and are heading into their eleventh year. This policy watch outlines changes to watch out for during 2024 Open Enrollment.

  • Preventive Services Use Among People with Private Insurance Coverage

    Issue Brief

    This analysis of claims data estimates that six in ten people with private health insurance - or about 100 million people - used at least one preventive service covered without any out-of-pocket costs through a provision of the Affordable Care Act (ACA) in a typical year prior to the COVID-19 pandemic (2018). The provision that requires most private health plans to cover many preventive services without any cost-sharing for their enrollees is being challenged in…

  • 2026 Medical Loss Ratio Rebates

    Issue Brief

    Insurers estimate they will pay $759.2 million in Medical Loss Ratio (MLR) rebates in 2026 to select individuals and employers that purchase their health coverage, according to a KFF analysis of preliminary data reported to state regulators. The estimated rebate for 2024 is less than rebates issued in most prior years.

  • What We Know So Far About 2026 ACA Marketplace Enrollment, Premiums, and Deductibles

    Issue Brief

    This analysis examines early indicators of how the expiration of enhanced premium tax credits has affected effectuated enrollment levels (i.e., enrollment among people who have paid their premiums), plan selections, and out-of-pocket costs in 2026, drawing on plan selection and effectuated enrollment data from the Centers for Medicare & Medicaid Services (CMS) and state-based Marketplace (SBM) Open Enrollment reports, as well as KFF survey data and individual market enrollment estimates from Wakely Consulting Group.