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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

Controlling Health Insurance Premiums: Perspectives from the States, the Federal Government and Industry

The Affordable Care Act creates a process for states and the Department of Health and Human Services to review “unreasonable” premium increases and provide information to consumers about the process. The rules governing this rate review process went into effect September 1, 2011. This briefing by the Kaiser Family Foundation,…

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The Henry J. Kaiser Family Foundation

Inside Deficit Reduction: What Now?

The Budget Control Act of 2011 tasked members of a “Super Committee” to find at least $1.2 trillion in deficit reduction over the next decade. Members did not reach an agreement by the November 23 deadline and as a result automatic spending cuts to defense and entitlement programs are set…

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The Henry J. Kaiser Family Foundation

Health Insurance Market Reforms: Pre-Existing Condition Exclusions

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…

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The Henry J. Kaiser Family Foundation

Explaining Health Care Reform: Questions About Health Insurance Exchanges

The Patient Protection and Affordable Care Act (PPACA), signed into law in March 2010, made broad changes to the way health insurance will be provided and paid for in the United States. PPACA created a new mechanism for purchasing coverage called Exchanges, which are entities that will be set up…

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The Henry J. Kaiser Family Foundation

Protection in Managed Care Plans: A Side-by-Side Comparison of Proposal Federal Legislation

Protection in Managed Care Plans: A Side-by-Side Comparison of Proposed Federal Legislation. A side-by-side comparison of the provisions for consumer protection in managed care plans contained in the House and Senate budget reconciliation bills and in eight other consumer protection bills currently under consideration by Congress. These bills, which would…

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The Henry J. Kaiser Family Foundation

The Impact of Managed Care Legislation: An Analysis of Five Legislative Proposals from California

This study analyzed five 1997 managed care consumer protection proposals currently or recently under consideration by the California state legislature: allowing consumers to sue their HMO (health maintenance organization) or managed care plan; expanding access to prescription drugs not approved by the health plan; expanded coverage of mental health services;…

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The Henry J. Kaiser Family Foundation

Managed Care Plan Liability: An Analysis of Texas and Missouri Legislation

This report analyzes recently enacted laws in Texas and Missouri that expand consumers' ability to sue their HMOs or other managed care plans for inappropriately denied care or similar problems.Report Report

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The Henry J. Kaiser Family Foundation

External Review of Health Plan Decisions — Policy Brief

An 8-page policy brief on the external review of health plan decisions to inform the policy debate in California and nationally. The policy brief covers external review systems in other states and the Medicare program, the current status of external review in California, and issues regarding the design and implementation…

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The Henry J. Kaiser Family Foundation Headquarters: 2400 Sand Hill Road, Menlo Park, CA 94025 | Phone 650-854-9400
Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.