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Estimating Federal Payments and Eligibility for Basic Health Programs: An Illustrative Example

In some states, policymakers and stakeholders are considering adoption of the Basic Health Program (BHP) option permitted under the Patient Protection and Affordable Care Act (ACA). Federal regulations allow BHP implementation beginning in 2015. Through BHP, consumers with incomes at or below 200 percent of the federal poverty level (FPL) who would otherwise qualify for subsidized qualified health plans (QHPs) offered in health insurance marketplaces instead are offered state-contracting standard health plans that provide coverage no less generous and affordable than what have been provided in the marketplace. To operate BHPs, states receive federal funding equal to 95 percent of the premium tax credits (PTCs) and cost-sharing reductions (CSRs) that BHP enrollees would have received if they had been covered through QHPs. This paper seeks to inform state-level analysts about the characteristics of BHP-eligible people in their state and how to use that information to estimate the approximate federal BHP payment amount per average BHP-eligible resident.

Kaiser Calculator Now Gives Consumers 2015 Zip Code-Specific Premium and Tax Credit Estimates for Marketplace Coverage

The Kaiser Family Foundation’s Health Insurance Marketplace Calculator now includes zip code-specific data on 2015 health plans that are being sold through the Affordable Care Act’s insurance marketplaces during the open enrollment period beginning Saturday, Nov. 15. With the new tool, consumers around the nation can generate estimates of their…

Tax Subsidies for Private Health Insurance

This brief describes the different forms of tax assistance for private health insurance, including subsidies offered through the Affordable Care Act’s marketplaces and benefits for people who are self-employed or who have employer-based coverage. The brief also provides examples of how the subsidies work and how the amounts may differ by income and type of coverage.

Coverage for Abortion Services and the ACA

This issue brief, Coverage of Abortion Services and the Affordable Care Act (ACA), summarizes the major coverage provisions of the ACA that are relevant for women of reproductive age, reviews current federal and state policies on Medicaid and insurance coverage of abortion services as they relate to the ACA, and presents national and state estimates on the availability of abortion coverage for women who are newly eligible for Medicaid or private coverage through the Marketplaces as a result of the ACA.

Survey Finds Approximately 3.4 Million Previously Uninsured Adult Californians Obtained Coverage Since Start of the Affordable Care Act’s First Open Enrollment Period

Immigration Status and Fears Pose Challenges to Further Expanding Coverage Among Hispanics Affordability Key Obstacle to Enrollment for Those Who Remain Uninsured MENLO PARK, Calif. — Nearly six in 10 (58%) previously uninsured Californians report getting health insurance since last summer, finds the second wave of the Kaiser Family Foundation’s…

Where are California’s Uninsured Now? Wave 2 of the Kaiser Family Foundation California Longitudinal Panel Survey

This second wave of the Kaiser Family Foundation’s California uninsured survey assesses the impact of the Affordable Care Act to date on state residents who were uninsured prior to open enrollment. The results capture the share of previously uninsured Californians who gained coverage or remained uninsured, how they feel about and interact with their new coverage options and what barriers to getting insurance remain. The report examines breakouts by race, coverage type, and other demographic factors.

How Much Is Enough? Out-of-Pocket Spending Among Medicare Beneficiaries: A Chartbook

This new analysis and chartbook examines out-of-pocket spending among Medicare beneficiaries, including spending on health and long-term care services and insurance premiums, using the most current year of data available from a nationally representative survey of people on Medicare. It explores which types of services account for a relatively large share of out-of-pocket spending, which groups of beneficiaries (including by age, gender, health status, and chronic conditions) are especially hard hit by high out-of-pocket costs, and trends in out-of-pocket spending between 2000 and 2010.