Consumer Appeal Rights in Private Health Coverage December 10, 2021 Issue Brief The Affordable Care Act (ACA) gives consumers the right to appeal private health plan claims denials and other adverse decisions, including the incorrect application of cost sharing, although limits apply. This issue brief describes consumer access to appeals and limits on appeal rights that have been adopted through federal regulations.
Marketplace Sign-ups Increased by 21% in 2022 January 28, 2022 Slide Forty-seven states saw Marketplace enrollment increase, ranging from 1% in Rhode Island to 42% in Texas. In 20 states, enrollment increased by more than 20%.
Many Workers, Particularly at Small Firms, Face High Premiums to Enroll in Family Coverage, Leaving Many in the ‘Family Glitch’ April 12, 2022 Issue Brief Data from the KFF Employer Health Benefits Survey demonstrates that some workers face very high contribution amounts for family coverage, including 12% who would have pay at least $10,000 annually in premiums for a family of four. These are the workers most likely to benefit from a fix to the ‘family glitch’.
For ACA Enrollees, How Much Premiums Rise Next Year is Mostly up to Congress May 18, 2022 Blog Most customers with coverage through Affordable Care Act’s marketplaces will face big premium increases next year if Congress doesn’t extend the temporary enhanced tax credits included in the American Rescue Plan Act (ARPA) of 2021. If the outcome isn’t clear by summer, fall open enrollment could be a mess.
Private Insurers Expect to Pay $1 Billion in Rebates to Consumers This Year for Setting Premiums Too High Relative to Medical Costs June 1, 2022 News Release Private insurance companies are expecting to pay out $1 billion in rebates to consumers this fall under an Affordable Care Act provision that requires insurers to spend the bulk of customers’ premium payments on care, a new KFF analysis finds. Rebates are based on insurers’ experiences over the previous three…
Falling off the Subsidy Cliff: How ACA Premiums Would Change for People Losing Rescue Plan Subsidies June 30, 2022 Blog This post examines what would happen to ACA marketplace premiums for enrollees with incomes more than four times the federal policy level if the enhanced American Rescue Plan Act subsidies expire, including variations by state .
ACA’s Maximum Out-of-Pocket Limit Is Growing Faster Than Wages July 20, 2022 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.
Five Things to Know about the Renewal of Extra Affordable Care Act Subsidies in the Inflation Reduction Act August 11, 2022 Blog As part of the Inflation Reduction Act, the Senate recently passed a three-year extension (through 2025) of enhanced subsidies for people buying their own health coverage on the Affordable Care Act Marketplaces. The enhanced subsidies increase the amount of financial help available to those already eligible and also newly expand subsidies to middle-income people, many of whom were previously priced out of coverage. Here’s what to know about the likely renewal of these subsidies:
2022 Survey of ACA Marketplace Assister Programs and Brokers October 17, 2022 Report This survey of Marketplace assister programs and brokers tracks the experiences of professionals signing people up for Affordable Care Act coverage. It also examines the role that these programs expect to play when the COVID-19 public health emergency (PHE) ends, potentially ending Medicaid eligibility for millions of Medicaid enrollees.
The Implications of the Most Recent Challenge to the ACA’s Preventive Care Requirement Could Affect Millions October 26, 2022 News Release A new brief explains the implications of the most recent legal challenge contesting the Affordable Care Act’s (ACA) requirement that most private insurance plans cover specific preventive care items and services—such as contraceptive services and supplies, and cancer screenings—at no cost to patients. In Braidwood Management v. Becerra, two Christian-owned…