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A new Kaiser Family Foundation analysis maps rates of pre-existing conditions across 129 metropolitan and micropolitan areas in the U.S., finding that even within the same state, the prevalence of such conditions can vary substantially. For example, 34 percent of residents of Florence, South Carolina have a pre-existing condition, but…
This brief estimates the share of adults with pre-existing conditions by metropolitan and micropolitan statistical area (MMSA), and finds that in some areas, nearly four in ten have so-called declinable medical conditions that could lead to denials of individual insurance coverage based on pre-ACA underwriting guidelines.
A new Kaiser Family Foundation brief examines out-of-network claims in large employer plans, and finds that a significant share of inpatient hospital admissions includes bills from out-of-network providers, often leaving patients exposed to “surprise medical bills” and high out-of-pocket costs. The analysis of part of the Peterson-Kaiser Health System Tracker, an online information…
Analysis: For Patients with Large Employer Coverage, About 1 in 6 Hospital Stays Includes an Out-of-Network Bill
A new Kaiser Family Foundation analysis of medical bills from large employer plans finds that a significant share of inpatient hospital admissions includes bills from providers not in the health plan’s networks, generally leaving patients subject to higher cost-sharing and potential additional bills from providers. Almost 18 percent of inpatient…
Enrollment in the Individual Insurance Market Continued to Fall in the First Quarter of 2018, With the 12 Percent Overall Decline Concentrated in Off-Exchange Plans
Enrollment in the individual insurance market continued to shrink in the first quarter of 2018, declining by 12 percent compared to the first quarter of 2017, according to a new analysis from the Kaiser Family Foundation. The decline was concentrated in off-exchange plans where enrollees are not eligible for Affordable…
Our analysis finds that, after increasing substantially (by 64% to 17.4 million people in 2015) following implementation of the ACA, enrollment in the individual market remained relatively unchanged in 2016 (at 17.0 million) then declined by 12% to 15.2 million in 2017. Enrollment has continued to fall in early 2018: first quarter enrollment has declined by 12% in 2018 compared to the first quarter of 2017 . Much of this decline in overall individual market enrollment was concentrated in the off-exchange market, where enrollees are not eligible for federal premium subsidies and therefore were not cushioned from the significant premium increases in 2017 and 2018. Despite the recent decline in overall individual market enrollment, there are still 14.4 million people enrolled as of the first quarter of 2018, compared to 10.6 million people in 2013.
Given the Trump Administration’s promotion of short-term limited-duration (STLD) health insurance policies, this brief examines what they mean for people with HIV. The analysis assesses whether people with HIV could enroll in STLD plans by applying to 38 plans across five states and getting in each case. It also assesses whether such plans could meet basic HIV care and treatment needs for someone diagnosed once enrolled. This finding takes on new importance in light of the Administration’s decision not to defend the ACA and to argue for eliminating pre-existing condition protections.
In an Axios column, Drew Altman analyzes the narrowing gap between growth in health spending and GDP and discusses why it matters. The big question, he says, is will the narrowing have staying power?