This analysis tracks the financial performance of insurers in the individual market by evaluating trends in the medical loss ratio (MLR) in the pre-ACA landscape from 2010 to 2013 and estimates the MLR for the first full year of Affordable Care Act implementation in 2014. Findings suggest that although performance varied among insurers, insurers overall had roughly comparable financial performance in 2014 as in recent prior years.
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This perspective addresses how insurance markets might respond if the US Supreme Court sides with the plaintiffs in the King v. Burwell case. The case challenges the legality of premium and cost-sharing subsidies for low- and middle-income people buying insurance in states where the federal government rather than the state is operating the marketplace under the Affordable Care Act (ACA).
This Policy Insight outlines eight questions that are likely to shape the U.S. global health response in the last two years of the current presidential term and beyond.
The Halbig case, if it prevails, would have far-reaching side effects on the Affordable Care Act’s employer mandate and the functioning of the individual insurance market.
This Policy Insight draws on the experiences of Medicare beneficiaries during Medicare’s annual enrollment period to consider whether consumers with health insurance coverage through the Affordable Care Act’s new marketplaces will shop for a better deal during their open enrollment season.
This Policy Insight take a deeper look at several key measures of the impact of the current Ebola epidemic in West Africa, including estimates of current cases, prevalence and death rates, as well as a consideration of the future projections of Ebola’s burden in the months to come.
Medical Debt Among Insured Consumers: The Role of Cost Sharing, Transparency, and Consumer Assistance
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.
In this Policy Insight, the Foundation’s Cristina Boccuti and Tricia Neuman examine how Congress’ effort to permanently stave off scheduled cuts in Medicare’s physician payments could affect what Medicare beneficiaries pay for their care — both in premiums and in other potential changes — to offset the cost of the Sustainable Growth Rate (SGR) “doc fix.”
One year into initial enrollment in the Medicare-Medicaid financial alignment demonstrations for dual eligible beneficiaries, some initial insights are beginning to emerge. This policy insight highlights key challenges and trends emerging in states’ demonstrations.
This policy insight examines the unexpected drop in Medicare’s per-beneficiary spending projections and its implications for beneficiaries and the program’s future.