This report summarizes first-hand accounts of seniors’ Medicare private plan decision making strategies, based on focus groups conducted in four cities. Seniors found the initial plan selection process overwhelming due to the volume of information they received and their inability to organize it. Few used the government’s online comparison tool, and those that did cite several shortcomings. Many relied on advice from sources they trust, including insurance agents, plan representatives, friends, family members, doctor’s offices and pharmacists. After they enroll in a plan, many seniors did not revisit their initial decision or review plan options without the strong provocation of a substantial increase in cost, change in coverage, or shift in personal health care needs. Moreover, they feared that a change in plans may disrupt their care, or lead to an unforeseen increase in out-of-pocket costs, and require them to learn new rules and requirements. They are doubtful they would end up in a plan that is appreciatively different or better for them. Overall, seniors preferred to have numerous choices in plans but would like personalized help and advice from experts to ease the process.
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This issue brief provides an overview of new Medicaid enrollment data released by Centers for Medicare and Medicaid Services and its interpretation to assess the influence of the ACA on Medicaid enrollment.
This data note discusses the details and timing of some of the private and federal surveys that will be used to look at how coverage has changed due to the Affordable Care Act. Different surveys offer different information and insight into coverage under the ACA, and we discuss the contributions and challenges in each type of effort.
This issue brief provides an overview of health coverage and care in the South today, with a focus on demographics, the impact of the ACA coverage expansions, and ongoing efforts to improve the delivery system and safety net in the South.
A Closer Look at the Impact of State Decisions Not to Expand Medicaid on Coverage for Uninsured Adults
The Affordable Care Act Medicaid expansion is a core component of the Affordable Care Act, designed to fill longstanding gaps in health coverage for adults. However, in states that do not implement the Medicaid expansion, millions of low-income adults that could have gained Medicaid will remain ineligible for the program. This fact sheet discusses the impact of state decisions not to expand Medicaid on health coverage for uninsured adults in states that are not currently implementing the ACA Medicaid expansion.
The South has faced longstanding disparities in health and health care, although significant variation exists between southern states. As a group, compared to those in other regions, Southerners are more likely to be uninsured, less likely to have access to needed health services, and more likely to experience a number of chronic health conditions. This chartbook provides key data on the demographic and economic characteristics of the southern population as well as their health status, health insurance coverage, and access to care today.
This issue brief reviews recent trends and developments in employer-sponsored retiree health coverage and examines the impact of recent legislation, such as the Medicare drug benefit and the Affordable Care Act (ACA) on retiree health coverage. The report describes leading strategies employers have been pursuing or considering to limit costs for retiree health benefits. In addition, the report considers the potential implications of proposals aimed at reducing federal spending for retiree health coverage and costs.
The Affordable Care Act’s Impact on Medicaid Eligibility, Enrollment, and Benefits for People with Disabilities
Medicaid is an important source of health insurance coverage for people with disabilities. This issue brief explains how Medicaid eligibility and benefits for people with disabilities are affected by the Affordable Care Act (ACA) rules as of 2014. Marketplace rules are discussed to the extent that they relate to Medicaid eligibility determinations for people with disabilities.
The expansion of Medicaid eligibility under the Affordable Care Act (ACA) fills in historical gaps in coverage for adults and is a key piece of the continuum of new coverage options. However, in states that do not expand Medicaid, nearly five million poor uninsured adults have incomes above Medicaid eligibility levels but below poverty and may fall into a “coverage gap” of earning too much to qualify for Medicaid but not enough to qualify for Marketplace premium tax credits.
As the Economy Improves, the Number of Uninsured Is Falling But Not Because of a Rebound in Employer Sponsored Insurance
Insurance coverage has rebounded since the end of the Great Recession, mostly because of increases in Medicaid coverage. Employer coverage stabilized after the recession, but mostly because of policies allowing young adults to stay on parents’ coverage. For other age groups, employer coverage rates are still falling. Ongoing shifts in employment status, industry type, income, demographics, and region have affected changes in coverage nationally.