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Quick Take: Essential Health Benefits: What Have States Decided for Their Benchmark?

Beginning on January 1, 2014, the Affordable Care Act (ACA) requires that all non-grandfathered individual and small group health insurance plans sold in a state, including those offered through an Exchange, cover certain essential health benefits (EHBs). As it stands today, many plans offered in the individual and small group…

Health Insurance Market Reforms: Pre-Existing Condition Exclusions

Insurers pursue multiple strategies to reduce the cost of covering enrollees with pre-existing conditions, or medical conditions and health problems that existed before the individual enrolled in a health plan. One strategy, the pre-existing condition exclusion, allows insurers to refuse to cover any costs associated with care for a pre-existing…

Quantifying the Effects of Health Insurance Rate Review

This report from the Kaiser Family Foundation analyzes the effect of government efforts to ensure that insurance premium increases are justifiable and provide value to consumers and small businesses. Rate review programs require insurers in the small group and individual markets to submit proposed rate increase requests to state or…

How Small Business Owners Get Health Insurance

As with any economic policy issue, there has been much discussion of how the Affordable Care Act (ACA) will affect small businesses. But, there’s been very little focus on how the health reform law will affect the owners of those businesses as people. As our recently released Employer Health Benefits…

Summary of Coverage Provisions in the Patient Protection and Affordable Care Act

This short summary describes the health coverage provisions contained in the final version of the Affordable Care Act signed into law in March 2010, including the individual mandate requirements, expansion of public programs, health insurance exchanges, changes to private insurance and employer requirements.

Explaining Health Care Reform: Questions About Health Insurance Subsidies

To encourage broad participation in health insurance and provide affordable coverage for families, the Patient Protection and Affordable Care signed into law in March 2010 includes provisions to lower premiums and cost-sharing requirements for Americans with low and modest incomes. This brief describes the subsidies available in the law, including…

Is a Death Spiral Inevitable If There is No Mandate?

If the Supreme Court acts within the next couple of weeks to overturn the individual mandate in the Affordable Care Act (ACA) while leaving the rest of the law intact, expect to hear a lot about how the individual insurance market will be destined for a “death spiral.” When compared…

Kaiser Survey Probes Health Insurance Brokers’ Views on Insurance Trends, ACA

A new nationally representative survey of 500 health insurance agents and brokers working in the individual and small group markets by the Kaiser Family Foundation explores their outlook on market trends and views on the Affordable Care Act (ACA). The survey finds that many agents are seeing steep increases in premiums…

The High and Rising Costs Of Health Care: What Can Be Done?

The Alliance for Health Reform, the Kaiser Family Foundation, and several cosponsors held the final event in a three-part series of discussions on costs, the factors driving them up and what (if anything) can be done about them. This briefing and others in the series take an in-depth look at…

Health Insurance Market Reforms: Rate Restrictions

Rate restrictions limit how much insurance companies can vary premiums charged to individuals and businesses based on factors such as health status, age, tobacco use and gender. Currently, federal law does not place any limits on the ways that insurance companies set their premium rates. However, beginning January 1, 2014,…