Most people get their health care through some form of managed care plan – a health maintenance organization, preferred provider organization, or point-of-service option. Most of the time, people receive the care they need, but the potential exists for disagreements over the services that will be provided or paid for…
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With the open enrollment period for health insurance exchanges less than six months away, consumers are already asking questions about their new health care options under the Affordable Care Act (ACA). Even in the age of digital information, hands-on consumer assistance could play a key role in helping people understand…
A study in the March/April 2007 issue of Health Affairs analyzes the impact of state tort reforms on physician malpractice claims. The study finds that the tort law changes have had a measurable but limited impact on physician malpractice claims, depending on the type and strength of the tort reform. Commissioned by…
This report, based on focus groups with adults in a variety of circumstances, highlights the experiences of Massachusetts residents in obtaining health coverage, accessing health care services and managing out-of-pocket costs in the wake of the state’s 2006 health reform law. Report (.pdf)
This fact sheet explains the Medical Loss Ratio requirement under the Affordable Care Act (ACA). The MLR provision limits the portion of premium dollars health insurers may spend on administration, marketing, and profits. Under health care reform, health insurers must publicly report the portion of premium dollars spent on health care and quality improvement and other activities in each state they operate. Insurers failing to meet the applicable standard must pay rebates to consumers and businesses.
This short cartoon explains the problems with the current health care system, the health reform changes that are happening now, and the big changes coming in 2014 as part of the Affordable Care Act (ACA). You can view the video on our site and it is also available on YouTube.
Medicaid Expansion through Premium Assistance: Key Issues for Beneficiaries in Arkansas’ Section 1115 Demonstration Waiver Proposal
This issue brief provides background about Medicaid premium assistance in the individual health insurance market, summarizes major components of Arkansas’ Section 1115 demonstration waiver application to implement the Affordable Care Act’s Medicaid expansion through premium assistance, and considers key issues affecting beneficiaries.
This testimony by the Foundation’s Karen Pollitz before the Equal Employment Opportunity Commission included background on wellness programs, wellness incentives and nondiscrimination since 1996, and questions and issues related to proposed regulations governing the design and application of wellness programs offered in conjunction with employer-sponsored group health plans.
This fact sheet compares the two Medicaid premium assistance authorities (state plan option and demonstration waiver) and identifies key beneficiary protections in Medicaid expansion premium assistance programs.
Rate review is the process by which insurance regulators review health plans’ new or renewed rates for insurance policies in order to ensure that the rates charged are based on accurate, verifiable data and realistic projections of health costs. Historically, state insurance departments have conducted rate review, but under the…