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The Numbers Behind “Young Invincibles” and the Affordable Care Act

As enrollment statistics in the new health insurance marketplaces start to become available, there is a growing focus on whether the enrollment of so-called “young invincibles” will be sufficient to keep insurance markets stable. Enrollment of young adults is important, but not as important as conventional wisdom suggests since premiums…

Explaining Health Care Reform: Risk Adjustment, Reinsurance, and Risk Corridors

This report examines the premium stabilization programs under the Affordable Care Act (ACA). Risk Adjustment, Reinsurance, and Risk Corridors — also called the Three R’s — will work in the early years of health reform to stabilize premiums and promote insurer competition on the basis of quality and promote market stability.

A Guide to the Supreme Court’s Review of the Contraceptive Coverage Requirement

This issue brief dissects the issues raised by the legal challenges to the Affordable Care Act’s requirement that private insurance plans include contraception as part of their coverage of preventive services for women. Over 40 for-profit corporations and over 40 nonprofit corporations have filed lawsuits claiming that the requirement to provide their employees with contraceptives violates their religious rights. On November 26, 2013, the Supreme Court agreed to hear two cases filed by for-profit corporations, Hobby Lobby and Conestoga Wood Specialties, that claim that this requirement violates their religious rights. At the crux of these cases is a question that the Supreme Court has not previously addressed: Do for-profit corporations have religious protections under the 1993 Religious Freedom Restoration Act and the First Amendment? The brief provides background on how the ACA’s contraceptive requirement works, summarizes some of the legal challenges brought by for-profit and non-profit organizations and discusses the implications of potential rulings by the Supreme Court.

State-by-State Estimates of the Number of People Eligible for Premium Tax Credits Under the Affordable Care Act

Key provisions of the 2010 Affordable Care Act (ACA) create new Marketplaces for people who purchase insurance directly and provide new premium tax credits to help people with low or moderate incomes afford that coverage. This analysis estimates that about 17 million people who are now uninsured or who buy insurance on their own (“nongroup purchasers”) will be eligible for premium tax credits in 2014. This issue brief provides national and state estimates for tax credit eligibility for people in these groups.

Obamacare y Usted: Si compra seguro médico en el mercado individual

Si usted compra su plan de salud por su cuenta (en vez de tener cobertura a través de su empleador), usted tendrá nuevas opciones para tener su cobertura, pero la Ley del Cuidado de Salud a Bajo Precio requiere que usted esté asegurado o será multado. Qué está cubierto Bajo…

Obamacare y Usted: Si tiene seguro médico a través de un empleador

Si usted tiene cobertura de beneficios de salud a través de su empleador o del empleador de un miembro de su familia, usted probablemente pueda mantener esa cobertura y no tener que hacer ningún cambio. En la mayoría de los casos, la cobertura de su empleador satisface los requerimientos de…

Medicare Advantage 2014 Spotlight: Plan Availability and Premiums

This data spotlight report examines trends in the Medicare Advantage marketplace, including the choices available to Medicare beneficiaries in 2014, premium levels and other plan features. Medicare beneficiaries, on average, will have 18 private Medicare Advantage plans available to them in 2014, reflecting both new plans entering the market and old plans exiting it. If Medicare Advantage enrollees remain in their current plans, average monthly premiums will rise by almost $5 per month, or 14 percent, to $39 per month. The analysis also examines some benefits provided by Medicare Advantage plans including drug coverage and caps on out-of-pocket spending, and finds that average out-of-pocket limits across all plans will climb 11 percent to $4,797 in 2014. Additionally, this analysis examines changes in the types of plans available (HMOs, PPOs, etc.), including special needs plans in 2014.

The Next Big Health-Care Issue

Drew Altman, in The Wall Street Journal‘s Think Tank, writes that the next big concern for the Affordable Care Act (ACA) will be how much premiums increase in exchanges for 2015. He discusses the factors to focus on to put this issue in perspective when states report premium increases.

How are Seniors Choosing and Changing Health Insurance Plans?

This report summarizes first-hand accounts of seniors’ Medicare private plan decision making strategies, based on focus groups conducted in four cities. Seniors found the initial plan selection process overwhelming due to the volume of information they received and their inability to organize it. Few used the government’s online comparison tool, and those that did cite several shortcomings. Many relied on advice from sources they trust, including insurance agents, plan representatives, friends, family members, doctor’s offices and pharmacists. After they enroll in a plan, many seniors did not revisit their initial decision or review plan options without the strong provocation of a substantial increase in cost, change in coverage, or shift in personal health care needs. Moreover, they feared that a change in plans may disrupt their care, or lead to an unforeseen increase in out-of-pocket costs, and require them to learn new rules and requirements. They are doubtful they would end up in a plan that is appreciatively different or better for them. Overall, seniors preferred to have numerous choices in plans but would like personalized help and advice from experts to ease the process.