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Survey of Physicians and Nurses

A national random survey of 1053 doctors and 768 nurses on their experiences with and attitudes towards health plans. The survey provides quantitative information from doctors and nurses about their non-elderly patients, as well as verbatim descriptions of patient experiences with health plan decisions, including doctors’ judgments on the consequences…

Alternative Approaches to Liability: Models for Health Plan Liability

This report looks at the different ways in which liability is handled in a number of industries, and explores how these models might apply to health plans. The report also discusses health plan liability in the context of the ongoing Consumer Protection debate.Report: Models for Health Plan Liability

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…

Statement of Gary Claxton to NAIC Exchanges (B) Subgroup

Kaiser Family Foundation Vice President Gary Claxton, who directs the Foundation’s Marketplace Policy Project, testified July 22, 2010, at a public hearing before the National Association of Insurance Commissioners’ Exchanges (B) Subgroup established by the health reform law.  Testimony (.pdf)

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…

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…

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…

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