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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  • Surprise Medical Bills are Ending, But Controversy Continues

    Perspective

    In this column for the JAMA Health Forum, Larry Levitt examines how the No Surprises Act that prohibits unexpected out-of-network charges for patients could lead to lower payment rates and revenues for some doctors and other care providers.

  • Preventive Services Use Among People with Private Insurance Coverage

    Issue Brief

    This analysis of claims data estimates that six in ten people with private health insurance - or about 100 million people - used at least one preventive service covered without any out-of-pocket costs through a provision of the Affordable Care Act (ACA) in a typical year prior to the COVID-19 pandemic (2018). The provision that requires most private health plans to cover many preventive services without any cost-sharing for their enrollees is being challenged in…

  • Medicare Advantage Insurers Report Much Higher Gross Margins Per Enrollee Than Insurers in Other Markets

    News Release

    A new analysis of health insurers’ 2021 financial data shows that insurers continue to report much higher gross margins per enrollee in the Medicare Advantage market than in other health insurance markets. The analysis examines insurers’ financial data in the Medicare Advantage, Medicaid managed care, individual (non-group), and fully insured group (employer) markets. In 2021, Medicare Advantage insurers reported gross margins averaging $1,730 per enrollee, at least double the margins reported by insurers in the…

  • 2021 Premium Changes on ACA Exchanges and the Impact of COVID-19 on Rates

    Issue Brief

    This brief summarizes premium rate filings in all 50 states and the District of Columbia and finds the majority of rate changes for 2021 are moderate, with increases or decrease of a few percentage points. Insurers say the COVID-19 pandemic is putting both upward and downward pressure on health costs in 2021.

  • A Look at People Who Have Persistently High Spending on Health Care

    Issue Brief

    This analysis looks at the amounts and types of health spending for people with employer-based health insurance who have continuing high health care spending. It finds that, among people with three consecutive years of coverage from a large employer, just 1.3 percent of enrollees accounted for almost 20 percent of overall spending in 2017. This group – people in the top five percent of spending in each of the three years from 2015 to 2017…

  • Poll: Strong Initial Support for a Public Option, But Arguments Can Significantly Shift Views

    News Release

    Health Care Remains a Top Issue for Democrats Heading into Next Debates; At This Stage, More Want to Hear About Candidates’ Difference than Contrasts with President Trump The 2020 presidential election may be shaping up to be another election cycle focused on health care, with Democratic candidates offering competing proposals aimed at expanding coverage and controlling costs and a pending legal battle over the constitutionality of the Affordable Care Act. The latest KFF tracking poll…

  • Health Insurer Financial Performance Through September 2020

    Issue Brief

    In this brief, we analyze third quarter data from 2018 to 2020 to examine how insurance markets performed financially through the end of September. Average margins remained relatively high compared to the same point in recent years, suggesting many insurers remained profitable even as non-COVID-related care returned in the summer and fall.

  • For 3rd Year in a Row, More Insurers are Entering the ACA Marketplaces, Creating More Options for Consumers

    News Release

    For the third straight year, more insurers are entering the Affordable Care Act’s marketplaces and expanding their service areas, creating more options for consumers seeking to buy their own insurance for 2021, a new KFF analysis finds.  The analysis finds 30 insurers joining the marketplace across 20 states, and another 61 insurers are expanding their services within states that they already served. More than a third of counties (1,207, or 38%) will have more insurers…