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April 24, 2019 News Release

Poll: Most Americans Want Congress to Prioritize Targeted Actions that Address Personal Health Care Costs; Fewer Cite Broader Reforms like Medicare-for-All and ACA Repeal as Top Priorities

Most Do Not Want the Supreme Court to Overturn the ACA or its Pre-Existing Conditions Protections When it comes to tackling pressing health care issues, incremental actions to address personal health care costs take precedence over broader, more partisan reforms for most Americans, according to the latest KFF Health Tracking…

April 15, 2019 Issue Brief

How Affordability of Health Care Varies by Income among People with Employer Coverage

This analysis for the Peterson-Kaiser Health System Tracker uses information from the Current Population Survey to look at the average amounts and the shares of family income people in working families with employer-based coverage pay out-of-pocket toward their premiums and direct payments for medical care. It finds that lower income families spend a greater share of their income on health costs than those with higher incomes, and that health status of family members is associated with higher out-of-pocket expenses.

April 15, 2019 Perspective

For Low-Income People, Employer Health Coverage is Worse Than ACA

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.

March 26, 2019 Fact Sheet

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 Affordable Care Act’s (ACA) individual mandate is unconstitutional and that the entire law should be struck down as a result. This brief considers the complex and far-reaching impact were the entire law ultimately held to be invalid.

March 6, 2019 Issue Brief

Ask KFF: Karen Pollitz Answers 3 Questions on Why Insurers Deny Claims

Karen Pollitz, senior fellow for health reform and private insurance at KFF, answers three questions about denied claims and how the federal government may change the data insurers are required to report on this issue.

February 25, 2019 News Release

Analysis: Marketplace Plans Denied an Average of Nearly One in Five Claims in 2017 with Wide Variations across Insurers

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…

February 25, 2019 Issue Brief

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.

February 1, 2019 Issue Brief

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…

January 31, 2019 Perspective

The Quiet, Steady Rise of Employer Health Coverage

This Drew Altman column in Axios reveals an uptick in the number of Americans with employer coverage, and discusses the implications for policy and politics.

January 29, 2019 Issue Brief

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.

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