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Establishing Health Insurance Marketplaces: An Overview of State Efforts

Figure 1: State Decisions for Creating Health Insurance Marketplaces State-based health insurance marketplaces, or exchanges, are a key component of the Affordable Care Act (ACA), and the places where individuals and small businesses will be able to shop for coverage. States can build a fully state-based…

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…

Coverage of Colonoscopies Under the Affordable Care Act’s Prevention Benefit

The Affordable Care Act (ACA) requires private health insurers to cover recommended preventive services such as colonoscopies without any patient cost-sharing. This report finds that confusion over whether colon cancer screenings are preventive care or treatment means patients sometimes receive unexpected bills for the procedure. The report examines cost-sharing practices for colorectal screenings through interviews with experts and officials in the medical and insurance industries.

This report was co-authored by The Kaiser Family Foundation, American Cancer Society, and National Colorectal Cancer Roundtable.

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.

A Guide to the Supreme Court’s Affordable Care Act Decision

This policy brief describes the Supreme Court’s decision on the Affordable Care Act and looks ahead to the implementation of health reform now that questions about the constitutionality of the law have been resolved. Brief (.pdf)

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…

The Part D Experience: What are the Lessons for Broader Medicare Reform?

Launched in 2006, Medicare added a prescription drug benefit that relies entirely on private plans, while, for other benefits, beneficiaries have a choice between private health plans and traditional fee-for-service Medicare. As policymakers consider changes to Medicare that would give an even greater role to private health plans in caring…

Federal Funding Under the Affordable Care Act

This fact sheet provides highlights from an analysis tracking the flow of federal Affordable Care Act funds to states as reporter in the Department of Health and Human Services grant database as well as periodic reports from HHS and the Internal Revenue Service. The analysis distinguishes between funds awarded to…

The Health Reform Law’s Medicaid Expansion: A Guide to the Supreme Court Arguments

One significant element of the pending U.S. Supreme Court case challenging the Affordable Care Act is the constitutionality of the law’s Medicaid expansion. This provision of the law requires states that choose to participate in the Medicaid program to cover nearly all adults under age 65 with household incomes at…