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Potential Impact of Texas v. U.S. Decision on Key Provisions of the Affordable Care Act

On December 14, 2018, a federal trial court judge ruled that the entire Affordable Care Act (ACA) is unconstitutional in Texas v. U.S. While the trial court’s ruling is likely not the last word on the ACA’s constitutionality, this brief considers the complex and far-reaching impact were the entire law ultimately held to be invalid.

Claims Denials and Appeals in ACA Marketplace Plans

Based on an analysis of transparency data released by the Centers for Medicare and Medicaid Services (CMS), this brief assess claims denials and appeals among issuers offering individual market coverage on healthcare.gov and finds that 19% of in-network claims were denied by issuers in 2017, with denial rates for specific issuers varying significantly around this average, from less than 1% to more than 40%. Consumers appealed less than 1% of denied claims.

Long-Term Trends in Employer-Based Coverage

A new issue brief looks at long-term trends in employer-based health insurance coverage, and finds that although the share of nonelderly Americans with employer-based health insurance has risen modestly in recent years, the long-term trend still shows a decline.  If coverage rates had stayed at the 1999 level (67.3%), almost 24…

Testimony: Pre-Existing Conditions and Health 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. 

Women’s Health Insurance Coverage

This factsheet reviews major sources of coverage for women residing in the U.S. in 2017, discusses the impact of the ACA on women’s coverage, and the coverage challenges that many women continue to face.