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Health Plan Liability — Policy Brief

An 8-page policy brief to inform the policy debate in California about health plan liability issues, including barriers to lawsuits (ERISA), liability approaches used in other industries, and potential impact on premiums. The brief includes a variety of perspectives presented by speakers at a California Health Policy Roundtable held in…

Update on Individual Health Insurance

This report provides information about the individual health insurance market using data from the largest vendor of this type of insurance, eHealthInsurance. The report includes who is buying individual insurance, what they are actually paying for the insurance, and buying patterns. It is the first in an up-coming series of…

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

Side-By-Side Comparison Of Proposed Federal Legislation For Consumer Protection In Managed Care PlansNicole Tapay, Karen Pollitz, Jalena CurtisInstitute for Health Care Research and Policy Georgetown University Medical CenterJuly 18, 1997Issue SummaryOver the past decade, an increasing number of Americans have been receiving their health care coverage through HMOs, PPOs and…

Pulling it Together: Last Week’s Health Reform “Shocker”

Last week we learned that health reform could cost the federal government at least a trillion dollars over ten years, and that it will be really difficult to forge bipartisan agreement on legislation and keep major interest groups on board. This obviously brought more angst to the deliberations, several Republicans…

Spending To Survive: Cancer Patients Confront Holes in the Health Insurance System

This report highlights the severe challenges cancer patient may face in paying for life-saving care even when they have private health insurance. Jointly authored by the Kaiser Family Foundation and the American Cancer Society, the report profiles 20 patients and illustrates the potential difficulties people diagnosed with cancer or other…

Explaining Health Care Reform: What Is An Employer “Pay-or-Play” Requirement?

To broaden coverage, some health reform proposals would require employers to offer coverage or pay to help finance subsidies for those without access to affordable coverage. These types of reforms are often referred to as “pay-or-play” policies. The brief explains the concept and policy implications of employer pay-or-play proposals, which…

Uniform Coverage Summaries for Consumers

This brief explains the proposed federal rule that requires private health plans to provide a short, easy-to-read uniform summary of benefits and coverage to all health insurance applicants and enrollees. The rule, which implements a provision in the Affordable Care Act (ACA), is intended to make it simpler for consumers…

Health Insurance Market Reforms: Guaranteed Issue

Guaranteed issue laws require insurance companies to issue a health plan to any applicant – an individual or a group – regardless of the applicant’s health status or other factors. Currently, in most states, insurance companies can deny nongroup coverage to people based on their health status or their medical…