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Coordinating Coverage and Care in Medicaid and Health Insurance Exchanges

The Kaiser Commission on Medicaid and the Uninsured convened a roundtable discussion on August 31, 2010 with a group of national and state experts to discuss key issues related to coordinating coverage and care in Medicaid and the new Health Insurance Exchanges under health reform. The Patient Protection and Affordable…

Pulling It Together: What Conservatives Won In Health Reform (And Don’t Seem to Know It)

Conservatives obviously don’t like what they call “Obamacare” because they think it expands the role of government too much and spends too much money.  But ironically, the Affordable Care Act (ACA) actually promotes — though not explicitly — something that has been a fundamental objective of conservatives in health care…

Pulling It Together: Predictions

I usually don’t make predictions, unless they are backed up by the kind of statistical modeling we often produce.  But here are three predictions I am confident about that form the basis of this latest column. GROUP HEALTH INSURANCE PREMIUMS WILL CONTINUE TO RISE AT HISTORICALLY MODERATE LEVELS, AT LEAST…

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…

What the Actuarial Values in the Affordable Care Act Mean

The Patient Protection and Affordable Care Act (PPACA) establishes four levels of coverage based on the concept of “actuarial value,” which represents the share of health care expenses the plan covers for a typical group of enrollees. As plans increase in actuarial value – bronze, silver, gold, and platinum –…

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.

The Stakes Beyond the Halbig Lawsuit

In a column for The Wall Street Journal’s Think Tank, Drew Altman discusses if the legal court cases about whether the government can provide tax credits to people in the Affordable Care Act’s federal health exchanges will be perceived by the American people as a legitimate legal question or as more inside-Washington politics.

The Potential Side Effects of Halbig

The Halbig case, if it prevails, would have far-reaching side effects on the Affordable Care Act’s employer mandate and the functioning of the individual insurance market.

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.