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Explaining Health Care Reform: Medical Loss Ratio (MLR)

This fact sheet explains the Medical Loss Ratio requirement under the Affordable Care Act (ACA). The MLR provision limits the portion of premium dollars health insurers may spend on administration, marketing, and profits. Under health care reform, health insurers must publicly report the portion of premium dollars spent on health care and quality improvement and other activities in each state they operate. Insurers failing to meet the applicable standard must pay rebates to consumers and businesses.

The Cost of Cancer

This Kaiser Family Foundation documentary explores the financial consequences faced by three people, all privately insured, after being diagnosed with cancer. It was released in conjunction with a joint Kaiser/American Cancer Society report, “Spending To Survive: Cancer Patients Confront Holes in the Health Insurance System.” To download the video, right-click…

The Requirement to Buy Coverage Under the Affordable Care Act

Along with changes to the health insurance system that guarantee access to coverage to everyone regardless of pre-existing health conditions, the Affordable Care Act includes a requirement that many people be insured or pay a penalty. This simple flowchart illustrates how that requirement (sometimes known as an “individual mandate”) works.…

Premiums and Worker Contributions Among Workers Covered by Employer-Sponsored Coverage, 1999-2014

This graphing tool allows users to explore trends in workplace-sponsored health insurance premiums and worker contributions over time for different categories of employers based on results from the annual Employer Health Benefits Survey. Breakouts are available by firm size, region and industry, as well as for firms with relatively few or many part-time workers, higher- or lower-wage workers, and older or younger workers.

Health Reform Implementation Timeline

The health reform implementation timeline is an interactive tool designed to explain how and when the provisions of the Affordable Care Act will be implemented over the next several years.

Recent Premium Increases Imposed by Insurers Averaged 20% for People Who Buy Their Own Health Insurance, Kaiser Survey Finds

Facing Such Increases, Some Enrollees Switched To Lower-Cost Coverage People With Pre-Existing Conditions Much More Likely To Report Problems MENLO PARK, CA — People who buy their own insurance report that their insurers most recently requested premium increases averaging 20 percent, according to a new Kaiser survey examining the experiences…

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.