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The Henry J. Kaiser Family Foundation

Private Insurance Benefits and Cost-Sharing Under the ACA

The Department of Health and Human Services (HHS) recently released guidance on the two key components that determine the level of protection that private insurance plans will provide to consumers under health reform. The first involves the services that insurance plans must cover, and the second involves how much patients…

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The Henry J. Kaiser Family Foundation

Insurance Coverage of Contraceptives

In this post, we answer some of the key questions about the new contraceptive coverage policy generally, and more specifically, how it will be applied to religious organizations.

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The Henry J. Kaiser Family Foundation

Transparency and Complexity

This fall a new rule takes effect requiring all private health plans to offer a uniform, simple to read, summary of benefits and coverage (SBC).  The SBC will provide consumers with standardized information about how plans cover essential health benefits and what coverage limits and cost sharing applies. The SBC…

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The Henry J. Kaiser Family Foundation

Managing Medicaid Pharmacy Benefits: Current Issues and Options

This report examines reimbursement, benefit management and cost sharing issues in Medicaid pharmacy programs. The analysis, conducted by researchers from the Foundation’s Kaiser Commission on Medicaid and the Uninsured and Health Management Associates, focuses on the potential of several measures recently highlighted by Health and Human Services Secretary Kathleen Sebelius…

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The Henry J. Kaiser Family Foundation

Questions About Essential Health Benefits

The Institute of Medicine (IOM) recently issued its long-awaited report on defining the essential health benefits under the Affordable Care Act (ACA). As expected, the committee preparing the IOM report did not recommend which specific services should be covered, but rather discussed what the process should be for defining the essential benefits,…

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The Henry J. Kaiser Family Foundation

An Employer Health Benefits Balance Sheet

There seems to be growing interest in the question of how many employers will keep offering coverage to their full-time employees once the Affordable Care Act (ACA) is fully implemented in 2014, or instead will choose to stop offering coverage and pay a penalty. While there is some good analysis…

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The Henry J. Kaiser Family Foundation

Federal Core Requirements And State Options In Medicaid: Current Policies And Key Issues

Medicaid is a jointly financed partnership between the federal government and states. The federal-state financing and administrative structure of Medicaid provides a framework of federal core requirements along with broad state options for program design and administration. This issue brief presents an overview of the current Medicaid program framework, with…

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The Henry J. Kaiser Family Foundation

Restructuring Medicare’s Benefit Design: Implications for Beneficiaries and Spending

Several deficit-reduction plans have proposed combining Medicare’s separate deductibles for hospital and physician services, standardizing cost sharing across types of benefits, and establishing a new limit on annual out-of-pocket costs for beneficiaries. A new Kaiser Family Foundation study examines the potential implications of proposals to revamp Medicare’s cost-sharing requirements as…

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The Henry J. Kaiser Family Foundation

Medicaid: A Primer – Key Information on the Nation’s Health Coverage Program for Low-Income People

This primer provides an overview of Medicaid, the nation’s largest health coverage program, which covers more than 62 million low-income individuals, including children and families, people with disabilities and seniors who are also covered by Medicare. Medicaid also is the dominant source of the country’s long-term care financing. The program will expand significantly under the Affordable Care Act in 2014.

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The Henry J. Kaiser Family Foundation

An Analysis of the Share of Medicare Beneficiaries Who Would Benefit from an Annual Out-of-Pocket Maximum under Traditional Medicare Over Multiple Years

This analysis examines the share of Medicare beneficiaries who would be helped over time if the program were to add a limit on out-of-pocket spending to traditional Medicare. This analysis was conducted jointly with the Medicare Payment Advisory Commission (MedPAC) in response to a request made during a Feb. 26, 2013 hearing of the House Ways and Means’ Subcommittee on Health.

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