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The Henry J. Kaiser Family Foundation

Issues for Structuring Interim High-Risk Pools

One of the first provisions that would be implemented under federal health reform bills in the House and the Senate would establish a national high-risk pool program to offer coverage to otherwise uninsurable individuals during the interim period between enactment and implementation of broader health care reforms. High-risk pools provide…

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The Henry J. Kaiser Family Foundation

Insurer Rebates under the Medical Loss Ratio: 2012 Estimates

Beginning in 2011, the Affordable Care Act (ACA) requires insurance plans to pay out a minimum percentage of premium dollars towards health care expenses and quality improvement activities, limiting the amount spent on administrative and marketing costs and profit. Under the law, large group plans are required to spend at…

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The Henry J. Kaiser Family Foundation

Implementing New Private Health Insurance Market Rules

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…

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The Henry J. Kaiser Family Foundation

Implementation of Affordable Care Act Provisions to Improve Nursing Home Transparency, Care Quality, and Abuse Prevention

The Affordable Care Act (ACA) is the first comprehensive legislation since the Nursing Home Reform Act, part of the Omnibus Budget Reconciliation Act of 1987 (OBRA ’87), to expand quality of care-related requirements for nursing homes that participate in Medicare and Medicaid and improve federal and state oversight and enforcement.…

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The Henry J. Kaiser Family Foundation

External Review of Health Plan Decisions in the States and Medicare – Report

External Review of Health Plan Decisions:An Overview of Key Program Features in the States and MedicareExternal Review of Health Plan Decisions:An Overview of Key Program Features in the States and MedicarePrepared for the Kaiser Family Foundation by:Karen Pollitz, M.P.P., Geraldine Dallek, M.P.H., and Nicole Tapay, J.D.Institute for Health Care Research…

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The Henry J. Kaiser Family Foundation

How Private Health Coverage Works: A Primer – 2008 Update

How Private Health Coverage Works: A Primer— 2008 UpdateThis primer explains the role and operations of private health coverage in the United States. Private health coverage is provided under a variety of different arrangements, including health insuring organizations regulated under state law and health plans sponsored by employers and employee organizations…

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The Henry J. Kaiser Family Foundation

Primers on Key Health Care Topics and Programs

The Kaiser Family Foundation maintains a number of primers providing overviews of key health care programs and issues. Written by Foundation staff, each primer provides key data and information that helps illustrate the topic and its relevance for the nation's health care system.Medicaid: A PrimerMedicare: A PrimerThe Uninsured: A PrimerHealth…

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The Henry J. Kaiser Family Foundation

Cost Sharing for Health Care: France, Germany, and Switzerland

As policymakers in the United States weigh options for reform to the nation’s health care system, the level of cost sharing that consumers face when they receive services covered by their health plans is a major consideration, especially for those with serious health conditions. This background brief authored by Kaiser…

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The Henry J. Kaiser Family Foundation

The COBRA Subsidy and Health Insurance for the Unemployed

With the nation’s unemployment rate rising to its highest levels in decades as a result of the recession, many families have lost their employer-sponsored health coverage or are at risk of doing so. In an effort to help people maintain coverage after a layoff, the stimulus legislation known as the…

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The Henry J. Kaiser Family Foundation

Consumers’ Experience in Massachusetts: Lessons For National Health Reform

This report examines the impact of state health reform efforts on the lives of ordinary people in Massachusetts, including a look at coverage provided by both public programs and private sources. It focuses specifically on people’s ability to afford and obtain needed care. Report (.pdf)

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