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 four 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.
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The Affordable Care Act (ACA) has changed access to health coverage for millions of women across the nation, including a provision requiring most private health insurance plans to provide coverage for prescription contraceptives and services. On Thursday, April 16 at 9:30 a.m. ET, the Kaiser Family Foundation hosted a briefing to…
The Patient Protection and Affordable Care Act (ACA) requires most private plans to provide coverage for women’s preventive health care, including all prescribed FDA-approved contraceptive services, without cost sharing. To better understand how this provision is being implemented by health plans, Kaiser Family Foundation (KFF) staff, with the Lewin Group, reviewed the insurance plan coverage policies for 12 prescribed contraceptive methods (excluding oral contraceptives). This report presents information from 20 different insurance carriers in five states (California, Georgia, Michigan, New Jersey, and Texas) about how they are applying reasonable medical management (RMM) techniques in their coverage of women’s contraceptive services. The different forms of female birth control reviewed in this report include the contraceptive ring, the patch, injections, implants, intrauterine devices (IUDs), and sterilization.
A new Kaiser Family Foundation report released today finds how health insurance carriers are interpreting and implementing the Affordable Care Act’s contraceptive coverage requirement varies, limiting contraceptive options for some women. The ACA requires most private health insurance plans to cover a range of preventive services for women, including prescribed…
With Medicare and Medicaid turning 50 this year, this updated video provides a brief history of both programs, including: an examination of the health care, social and political landscape that gave rise to them, the significant ways each program has evolved over five decades, and the important roles they play in the U.S. health care system. The video includes archival footage, as well as commentary and perspective from policymakers, government officials and experts.
This issue brief examines the role that the Ryan White Program has played in helping HIV positive clients purchase insurance coverage from both a historical and an Affordable Care Act (ACA) era perspective. The ACA era analysis focuses on activities in five states during the first open enrollment period and looks specifically at insurance purchasing through the health insurance marketplaces. The states analyzed are California, Florida, Georgia, New York, and Texas.
Where Are States Today? Medicaid and CHIP Eligibility Levels for Adults, Children, and Pregnant Women
This fact sheet provides an overview of eligibility levels for parents, other non-disabled adults, children, and pregnant women in Medicaid and CHIP. The data are based on eligibility levels reported by states as of January 2015, updated to reflect state Medicaid expansion decisions as of April 2015. The findings highlight Medicaid’s expanded role for low-income adults under the Affordable Care Act (ACA) and its continued role as a primary source of coverage for children and pregnant women.
The Affordable Care Act (ACA) went into full effect on January 1, 2014, ushering in health insurance reforms and new health coverage options in Pennsylvania and elsewhere across the country. Pennsylvania is experiencing changes to its health care delivery system as the state expands Medicaid, provides new coverage options through the federal health insurance marketplace, streamlines application and enrollment processes for coverage programs, and implements new health care delivery system and payment reforms. This fact sheet provides an overview of population health, health coverage, and the health care delivery system in Pennsylvania in the era of health reform.
The House-passed legislation to repeal the Medicare Sustainable Growth Rate (SGR) includes a provision that would prohibit Medicare supplemental insurance (Medigap) policies from covering the Part B deductible for people who become eligible for Medicare beginning in 2020. A new Kaiser Family Foundation Data Note explores the implications of this…
Medigap Enrollment Among New Medicare Beneficiaries: How Many 65-Year Olds Enroll In Plans With First-Dollar Coverage?
On March 26, 2015, the House of Representatives passed H.R. 2, the Medicare Access and CHIP Reauthorization Act of 2015, which would replace the Sustainable Growth Rate (SGR) formula, among other changes; the bill is currently pending in the U.S. Senate. H.R. 2 includes a provision that would prohibit Medicare supplemental insurance (Medigap) policies from covering the Part B deductible for people who become eligible for Medicare on or after January 1, 2020. This data note looks at the number and share of “new” Medicare beneficiaries who would be affected by the Medigap provision in H.R. 2, if it had been implemented in 2010, using the most current data sources available, and examines trends in Medigap enrollment among new beneficiaries since 2000.