This issue brief dissects the issues raised by the legal challenges to the Affordable Care Act’s requirement that private insurance plans include contraception as part of their coverage of preventive services for women. Over 40 for-profit corporations and over 40 nonprofit corporations have filed lawsuits claiming that the requirement to provide their employees with contraceptives violates their religious rights. On November 26, 2013, the Supreme Court agreed to hear two cases filed by for-profit corporations, Hobby Lobby and Conestoga Wood Specialties, that claim that this requirement violates their religious rights. At the crux of these cases is a question that the Supreme Court has not previously addressed: Do for-profit corporations have religious protections under the 1993 Religious Freedom Restoration Act and the First Amendment? The brief provides background on how the ACA’s contraceptive requirement works, summarizes some of the legal challenges brought by for-profit and non-profit organizations and discusses the implications of potential rulings by the Supreme Court.
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This analysis provides the first national estimates of the expected impact of the Affordable Care Act’s (ACA) coverage expansions on people with HIV. The brief finds that close to 70,000 uninsured people with HIV who are in care could gain new coverage, including 47,000 through Medicaid were all states to expand their Medicaid coverage.
In states that do not implement the Medicaid expansion under the Affordable Care Act (ACA), many adults will fall into a “coverage gap” of earning too much to qualify for Medicaid but not enough to qualify for Marketplace premium tax credits. Nationwide, nearly five million poor uninsured adults are in this situation.This brief describes the population in the coverage gap and discusses the implications of them being left out of ACA coverage expansions.
This brief provides an overview of the many different paths to enrollment in Medicaid and CHIP, including paths created under the Affordable Care Act (ACA), and reviews the available national level data on enrollment through these avenues.
Health and Access to Care and Coverage for Lesbian, Gay, Bisexual, and Transgender Individuals in the U.S.
Lesbian, gay, bisexual, and transgender (LGBT) individuals often face challenges and barriers to accessing needed health services and, as a result, can experience worse health outcomes. Recent policy changes have the potential to impact how LGBT individuals access and receive health care. This issue brief examines population characteristics of the LGBT community including demographics, health challenges such as chronic conditions, HIV/AIDS epidemic and STIs, mental health and substance use, sexual and physical violence, adolescent and young adult health, and access to care and insurance coverage. Additionally, this brief examines the impacts of the Affordable Care Act (ACA) and the recent Supreme Court rulings on the Defense of Marriage Act (DOMA) and how these policy changes will impact insurance coverage and access to health care services.
The implementation of the Affordable Care Act (ACA) has focused attention on the composition of the nongroup market: how it looked before the new regulatory provisions take effect and how it will change afterwards. There are several ways of answering this question, depending on the time period for measuring enrollment and the information source. There is substantial turnover among people with nongroup coverage, which means that the number of people covered at the beginning of a year (or at any other point in time) is quite different than the number of people who keep that coverage throughout the whole year.
This report examines the causes and contributors to medical debt, medical bankruptcy, and other difficulties with medical bills among people with insurance. Through in-depth interviews of nearly two-dozen people and quantitative analysis of national survey data, the authors of this report find that in-network and out-of-net-work cost sharing primarily contribute to medical debt among the insured.
This brief explores key provisions of the Affordable Care Act (ACA) for people with HIV, and the opportunities and challenges for using the law to improve HIV care, particularly in light of the Supreme Court’s 2012 ruling on the law.
The report examines state Medicaid program policies regarding coverage of pregnancy-related services. It details state-level Medicaid eligibility and enrollment policies for pregnant women, as well as scope of coverage for prenatal and screening services, delivery and post-partum care, educational classes and support services.
This brief provides details of the benefit and cost-sharing rules that will govern the coverage available under health reform to these newly eligible adults Medicaid beneficiaries, and it identifies key considerations for state policymakers making Medicaid benefit design choices.