Private Insurance

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What Are the Recent Trends in Employer-Based Health Coverage?

Employer-sponsored health insurance is the largest source of health coverage for people under 65. This analysis examines who among people under 65 have employer coverage and which workers are offered and eligible for coverage at their jobs, using the Annual Economic and Social (March) Supplements of the Current Population Survey.

Employer sponsored health insurance

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  • The Cost of the Individual Mandate Penalty for the Remaining Uninsured

    Issue Brief

    This analysis provides estimates of the share of uninsured people eligible to enroll in the Affordable Care Act marketplaces who will be subject to the individual mandate penalty, and how those penalties are increasing for 2016. It also provides estimates of the number of people who could have a zero-dollar contribution or pay less for health insurance than the penalty, due to premium subsidies, and the number of people who would pay more for a…

  • Analysis of 2015 Premium Changes in the Affordable Care Act’s Health Insurance Marketplaces

    Issue Brief

    This analysis provides an early look at premium changes for individuals in the health insurance marketplaces, created under the Affordable Care Act (ACA), in major cities across 15 states plus DC. Although premium changes vary across and within states, premium changes for 2015 in general are modest when looking at low-cost plans. On average, individuals will pay slightly less in premiums for the benchmark silver plan in 2015 than in 2014.

  • Over-the-Counter Oral Contraceptive Pills

    Issue Brief

    Oral contraceptives are the most commonly used method of reversible contraception in the U.S. In July 2023, the FDA approved Opill, the first daily oral contraceptive pill to become available over the counter (OTC) without a doctor’s prescription. This issue brief provides an overview of OTC oral contraceptives and laws and policies related to insurance coverage.

  • KFF Survey of Consumer Experiences with Health Insurance

    Poll Finding

    The survey finds nearly six in 10 people with health insurance experienced a problem using their insurance in the past year, with even larger shares reporting problems among people who are sick or who have mental health needs. It includes data for people with different types of coverage, including employer, Marketplace, Medicare and Medicaid, and also examines affordability issues and mental health access.

  • Consumer Survey Highlights Problems with Denied Health Insurance Claims

    Issue Brief

    This Data Note includes major findings from the KFF Consumer Survey on consumer experiences with claim denials. Among those who used the most health care over the past year, 27% experienced a denied claim. More consumers with private insurance experienced denied claims compared to Medicaid or Medicare.

  • Consumer Appeal Rights in Private Health Coverage

    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.

  • Employer Responsibility Under the Affordable Care Act

    Other Post

    The Affordable Care Act does not require businesses to provide health benefits to their workers, but applicable large employers may face penalties if they don’t make affordable coverage available. The employer shared responsibility provision of the Affordable Care Act penalizes employers who either do not offer coverage or do not offer coverage that meets minimum value and affordability standards. These penalties apply to firms with 50 or more full-time equivalent employees. This flowchart illustrates how…

  • Another Year of Record ACA Marketplace Signups, Driven in Part by Medicaid Unwinding and Enhanced Subsidies

    Policy Watch

    Open enrollment for the Affordable Care Act (ACA) Marketplaces is about to wrap up with another record high number of people signing up for coverage. Factors that contribute to this increase include unwinding of the Medicaid continuous enrollment, increased subsidies from the American Rescue Plan and Inflation Reduction Act, and increased marketing, outreach, and enrollment assistance.

  • Survey of Health Insurance Marketplace Assister Programs

    Report

    This survey by the Kaiser Family Foundation of Navigators and other Marketplace consumer assistance programs under the Affordable Care Act (Obamacare) offers a nationwide analysis of the number and distribution of assisters and people they helped. The report examines the experience of programs in conducting outreach and enrollment assistance during the first open enrollment period. It also reviews the nature of help consumers needed applying for Medicaid or premium tax credits and understanding health insurance…

  • Medical Debt Among Insured Consumers: The Role of Cost Sharing, Transparency, and Consumer Assistance

    Perspective

    This policy insight examines medical debt among insured consumers, exploring how high cost sharing in health insurance plans can contribute, and explaining how greater transparency could help consumers avoid some financial pitfalls. It also provides an update on provisions of the Affordable Care Act meant to increase health plan transparency and bolster consumer assistance.