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This issue brief offers an early look into how competitive the health insurance exchanges (also called marketplaces) are under the Affordable Care Act in selected states. Through analysis of enrollment data released by seven states (California, Connecticut, Minnesota, New York, Nevada, Rhode Island, and Washington) this brief finds that exchange markets in California and New York are shaping up to be more competitive than their individual markets were in 2012 while those of Connecticut and Washington show less competition (less even market share distribution). In several states, market concentration of individual insurers have shifted significantly compared to the individual market prior to the ACA, pointing to the potential for greater price competition in the future and the influence of new entrants to the market.
On March 25th, the Supreme Court will hear two cases brought by for-profit corporations challenging the ACA’s contraceptive coverage rule on religious grounds. These two corporations are Hobby Lobby, a national chain of craft stores owned by a Christian family and Conestoga Wood Specialties, a cabinet manufacturer, owned by a Mennonite family. Beyond the impact on the ACA and contraceptive coverage, the Court’s decision may have implications for religious rights of employers and employees, as well as corporate and civil rights laws. This brief examines three fundamental questions raised by some of the 84 amicus briefs that have been submitted to the Court.
The February 2014 Kaiser Health Tracking Poll finds that those who are most likely to be customers in the Affordable Care Act (ACA)’s new insurance exchanges (the uninsured and those who purchase their own coverage) are more likely to prefer less costly plans with narrow provider networks over more expensive plans with broader networks, while the public overall has the opposite preference. Overall opinion of the ACA remains about the same as it has been since November, with just under half the public viewing the law unfavorably and just over a third having a favorable view.
This report examines the causes and contributors to medical debt, medical bankruptcy, and other difficulties with medical bills among people with insurance. Through in-depth interviews of nearly two-dozen people and quantitative analysis of national survey data, the authors of this report find that in-network and out-of-net-work cost sharing primarily contribute to medical debt among the insured.
This state report explains how the ACA expands coverage in West Virginia, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in West Virginia are eligible for Medicaid or financial assistance in the Marketplace. For states not expanding Medicaid, the report quantifies how many uninsured people fall into the “coverage gap,” meaning they will be ineligible for financial assistance in the Marketplace or for Medicaid in their state despite having an income below the federal poverty level.
The implementation of the Affordable Care Act (ACA) has focused attention on the composition of the nongroup market: how it looked before the new regulatory provisions take effect and how it will change afterwards. There are several ways of answering this question, depending on the time period for measuring enrollment and the information source. There is substantial turnover among people with nongroup coverage, which means that the number of people covered at the beginning of a year (or at any other point in time) is quite different than the number of people who keep that coverage throughout the whole year.
As enrollment statistics in the new health insurance marketplaces start to become available, there is a growing focus on whether the enrollment of so-called “young invincibles” will be sufficient to keep insurance markets stable. Enrollment of young adults is important, but not as important as conventional wisdom suggests since premiums…
This issue brief dissects the issues raised by the legal challenges to the Affordable Care Act’s requirement that private insurance plans include contraception as part of their coverage of preventive services for women. Over 40 for-profit corporations and over 40 nonprofit corporations have filed lawsuits claiming that the requirement to provide their employees with contraceptives violates their religious rights. On November 26, 2013, the Supreme Court agreed to hear two cases filed by for-profit corporations, Hobby Lobby and Conestoga Wood Specialties, that claim that this requirement violates their religious rights. At the crux of these cases is a question that the Supreme Court has not previously addressed: Do for-profit corporations have religious protections under the 1993 Religious Freedom Restoration Act and the First Amendment? The brief provides background on how the ACA’s contraceptive requirement works, summarizes some of the legal challenges brought by for-profit and non-profit organizations and discusses the implications of potential rulings by the Supreme Court.
This data spotlight report examines trends in the Medicare Advantage marketplace, including the choices available to Medicare beneficiaries in 2014, premium levels and other plan features. Medicare beneficiaries, on average, will have 18 private Medicare Advantage plans available to them in 2014, reflecting both new plans entering the market and old plans exiting it. If Medicare Advantage enrollees remain in their current plans, average monthly premiums will rise by almost $5 per month, or 14 percent, to $39 per month. The analysis also examines some benefits provided by Medicare Advantage plans including drug coverage and caps on out-of-pocket spending, and finds that average out-of-pocket limits across all plans will climb 11 percent to $4,797 in 2014. Additionally, this analysis examines changes in the types of plans available (HMOs, PPOs, etc.), including special needs plans in 2014.