Private Insurance

Health Care Affordability

BTD Health Policy in 2026

Health Policy in 2026

President and CEO Dr. Drew Altman forecasts eight things to look for in health policy in 2026. “First and foremost,” he writes, “is the role health care affordability will play in the midterms.” And, he notes: “The average cost of a family policy for employers could approach $30,000 and cost sharing and deductibles will rise again after plateauing for several years.”

View all of Drew’s Beyond the Data Columns

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  • The Flip Side of Higher Premiums: Better Coverage

    Perspective

    Time Magazine's recent cover story on health care – "Bitter Pill" by Steven Brill – has focused attention on hospital prices, especially for people paying out of their own pockets. This is not a new issue, but certainly one that deserves attention. However, what has been lost in the ensuing commentary on high hospital prices is that Brill’s article is as much about inadequate insurance, which is the reason why the patients he writes about…

  • Medicaid Spending Growth Per Enrollee Has Been Slower than Growth in Private Health Spending

    Feature

    Medicaid Spending Growth Per Enrollee Has Been Slower than Growth in Private Health Spending Download Source Urban Institute, 2010. Estimates based on data from Medicaid Financial Management Reports (HCFA/CMS Form 64), Medicaid Statistical Information System (MSIS), and KCMU/HMA enrollment data. Expenditures exclude prescription drug spending for dual eligible benficiaries to remove the effect of their transition to Medicare Part D in 2006  

  • Health Insurance Market Reforms: Portability

    Fact Sheet

    Most Americans have access to health insurance through an employer-sponsored health plan, a fact that has made changing or losing a job a complex issue for the purposes of maintaining health insurance. Moving to a new job can be hard if the employer does not offer health insurance, or if the new employer’s health plan is not as generous as the previous employer’s plan. And with limited protections for people with pre-existing conditions, many people…

  • Implementing New Private Health Insurance Market Rules

    Issue Brief

    With the Jan. 1, 2014 effective date for implementing major changes in the private insurance market under the Affordable Care Act (ACA) approaching, this brief looks at three proposed federal regulations released in late November 2012 that detail how the ACA’s rules will operate in the following areas: private insurance market reforms, essential health benefits and actuarial value, and wellness programs offered or required by employers under group health plans. These regulations deal with aspects…

  • Visualizing Health Policy: Health Coverage Under the Affordable Care Act (ACA)

    Other Post

    The December 2012 Visualizing Health Policy infographic is a flowchart illustrating the mechanisms by which people will get health coverage beginning in 2014. See the full-size infographic at The Journal of the American Medical Association. Visualizing Health Policy is a monthly infographic series produced in partnership with the Journal of the American Medical Association (JAMA). Each month’s infographic is freely available on JAMA’s website and is published in the print edition of the journal.

  • Visualizing Health Policy: Health Coverage Under the Affordable Care Act (ACA)

    Report

    Related Resources Study Highlights Role of Geography and Plan Shopping Under Medicare Premium Support System Medicare Part D: A First Look at Part D Plan Offerings in 2013 The Medicare Prescription Drug Benefit - An Updated Fact Sheet Online Consumer Guide to Medicare   The latest Visualizing Health Policy infographic is a flowchart illustrating the mechanisms by which people will get health coverage beginning in 2014. Medicare's Role and Future Challenges << Previous Visualizing Health…

  • Health Insurance Market Reforms: Rate Review

    Fact Sheet

    Rate review is the process by which insurance regulators review health plans’ new or renewed rates for insurance policies in order to ensure that the rates charged are based on accurate, verifiable data and realistic projections of health costs. Historically, state insurance departments have conducted rate review, but under the Affordable Care Act (ACA), federal regulators may review rate increases in some cases. This fact sheet explains how rate review works and how the ACA…

  • Quick Take: Essential Health Benefits: What Have States Decided for Their Benchmark?

    Fact Sheet

    Beginning on January 1, 2014, the Affordable Care Act (ACA) requires that all non-grandfathered individual and small group health insurance plans sold in a state, including those offered through an Exchange, cover certain essential health benefits (EHBs). As it stands today, many plans offered in the individual and small group markets lack access to key benefits; the Department of Health and Human Services (HHS) estimates that 62% of health plan enrollees in the individual market…

  • What Do They Mean When They Talk About Pre-Existing Health Conditions?

    Perspective

    One health care issue about which the presidential candidates acknowledge they have differences is how the health care system should treat people with pre-existing health conditions. People who have a health condition (such as an illness or pregnancy) or who are at higher than average risk of needing health care are referred to as having a pre-existing health condition. The insurance reform provisions of the Affordable Care Act (ACA), when they take effect in 2014, will…

  • Health Insurance Market Reforms: Pre-Existing Condition Exclusions

    Fact Sheet

    Insurers pursue multiple strategies to reduce the cost of covering enrollees with pre-existing conditions, or medical conditions and health problems that existed before the individual enrolled in a health plan. One strategy, the pre-existing condition exclusion, allows insurers to refuse to cover any costs associated with care for a pre-existing condition permanently or over a period of time. Beginning January 1, 2014, insurers in the individual and group markets will be prohibited from imposing pre-existing…