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Medical-Loss-Ratio-Graphic

Beyond Rebates: How Much Are Consumers Saving from the ACA’s Medical Loss Ratio Provision?

The Medical Loss Ratio (MLR) provision of the Affordable Care Act (ACA) saved consumers an estimated $2.1 billion last year, in the form of lower premiums and rebates, according to a new analysis by the Kaiser Family Foundation. Under health reform, insurers must issue consumer rebates if they fail to spend a certain portion of premium income on health care claims and quality improvement expenses, thereby limiting what they may spend on administrative expenses or keep as profits.

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The Henry J. Kaiser Family Foundation

Testimony: Wellness Programs and Nondiscrimination Under Employer-Sponsored Group Health Plans

This testimony by the Foundation’s Karen Pollitz before the Equal Employment Opportunity Commission included background on wellness programs, wellness incentives and nondiscrimination since 1996, and questions and issues related to proposed regulations governing the design and application of wellness programs offered in conjunction with employer-sponsored group health plans.

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The Henry J. Kaiser Family Foundation

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…

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home-promo-map-excchange

State Health Insurance Marketplace Profiles

Up-to-date state profiles give an in-depth look at each state’s progress in setting up marketplaces, formally known as exchanges, including the legislative process and the next steps.

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Flip Side

The Flip Side of Higher Premiums: Better Coverage

Time Magazine’s recent cover story on health care – “Bitter Pill” by Steven Brill – has focused attention on hospital prices, especially for people paying out of their own pockets. This is not a new issue, but certainly one that deserves attention. However, what has been lost in the ensuing…

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The Henry J. Kaiser Family Foundation

Health Insurance Market Reforms: Portability

Most Americans have access to health insurance through an employer-sponsored health plan, a fact that has made changing or losing a job a complex issue for the purposes of maintaining health insurance. Moving to a new job can be hard if the employer does not offer health insurance, or if…

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The Henry J. Kaiser Family Foundation

Implementing New Private Health Insurance Market Rules

With the Jan. 1, 2014 effective date for implementing major changes in the private insurance market under the Affordable Care Act (ACA) approaching, this brief looks at three proposed federal regulations released in late November 2012 that detail how the ACA’s rules will operate in the following areas: private insurance…

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jama_december2012_small

Visualizing Health Policy: Health Coverage Under the Affordable Care Act (ACA)

The December 2012 Visualizing Health Policy infographic is a flowchart illustrating the mechanisms by which people will get health coverage beginning in 2014. See the full-size infographic at The Journal of the American Medical Association. Visualizing Health Policy is a monthly infographic series produced in partnership with the Journal of…

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The Henry J. Kaiser Family Foundation

Visualizing Health Policy: Health Coverage Under the Affordable Care Act (ACA)

Related ResourcesStudy Highlights Role of Geography and Plan Shopping Under Medicare Premium Support SystemMedicare Part D: A First Look at Part D Plan Offerings in 2013The Medicare Prescription Drug Benefit – An Updated Fact SheetOnline Consumer Guide to Medicare The latest Visualizing Health Policy infographic is a flowchart illustrating the mechanisms…

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The Henry J. Kaiser Family Foundation

Health Insurance Market Reforms: Rate Review

Rate review is the process by which insurance regulators review health plans’ new or renewed rates for insurance policies in order to ensure that the rates charged are based on accurate, verifiable data and realistic projections of health costs. Historically, state insurance departments have conducted rate review, but under the…

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