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The Coverage Provisions in the Affordable Care Act: An Update

The Affordable Care Act (ACA) includes numerous reforms to the individual and group health insurance markets, expands Medicaid to more low-income adults, and creates health insurance Marketplaces where subsidies are available to lower the cost of coverage. These changes are designed to increase access to affordable health coverage. This brief examines these coverage provisions, provides an update on how they have been implemented, and assesses their impact.
FRAMEWORK OF THE ACA
Like previous attempts at health care reform, the ACA was structured to address the gaps and limitations of our public-private health insurance system. It builds on employer-based coverage, restructures the individual insurance market, and broadens access to and affordability of coverage by expanding Medicaid for the low-income population and extending tax subsidies for the purchase of private insurance to those with moderate incomes.

The Cost of Care with Marketplace Coverage

This brief and accompanying slides examine cost sharing – deductibles, copayments and coinsurance – in 2015 insurance plans sold on the Affordable Care Act’s (ACA) federally-facilitated marketplaces. The analysis looks at out-of-pocket limits, as well as cost sharing for hospital stays, physician visits, emergency room visits, and prescription drugs, for plans across the metal levels (platinum, gold, silver and bronze).

Visualizing Health Policy: Premium Changes in the Affordable Care Act’s Insurance Marketplaces 2014-2015

This Visualizing Health Policy infographic illustrates the change in monthly premiums by county, and select cities, from 2014 to 2015 for a 40-year-old person covered by the second-lowest-cost silver “benchmark” plan in the Affordable Care Act’s insurance marketplaces. Premium changes were greatest in Summit County, Colo. (45% decrease) and southeastern Alaska…

Analysis of 2015 Premium Changes in the Affordable Care Act’s Health Insurance Marketplaces

This analysis provides an early look at premium changes for individuals in the health insurance marketplaces, created under the Affordable Care Act (ACA), in major cities across 15 states plus DC. Although premium changes vary across and within states, premium changes for 2015 in general are modest when looking at low-cost plans. On average, individuals will pay slightly less in premiums for the benchmark silver plan in 2015 than in 2014.

New Spanish-Language Cartoon and Calculator to Help Consumers Understand Health Insurance

The Kaiser Family Foundation today released two new Spanish-language tools to help consumers better understand health insurance as they shop for plans during open enrollment for the Affordable Care Act’s marketplaces and in other venues. El seguro de salud, explicado: ¡los YouToons lo tienen cubierto!, is a Spanish version of…

Mapping Marketplace Enrollment

This interactive zip code tool and map displays enrollment in the Health Insurance Marketplaces as a share of the potential market in small geographic areas across the country.

Kaiser Calculator Now Gives Consumers 2015 Zip Code-Specific Premium and Tax Credit Estimates for Marketplace Coverage

The Kaiser Family Foundation’s Health Insurance Marketplace Calculator now includes zip code-specific data on 2015 health plans that are being sold through the Affordable Care Act’s insurance marketplaces during the open enrollment period beginning Saturday, Nov. 15. With the new tool, consumers around the nation can generate estimates of their…