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Explaining Health Care Reform: What Is An Employer “Pay-or-Play” Requirement?

To broaden coverage, some health reform proposals would require employers to offer coverage or pay to help finance subsidies for those without access to affordable coverage. These types of reforms are often referred to as “pay-or-play” policies. The brief explains the concept and policy implications of employer pay-or-play proposals, which…

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.

Reconciliation of Advance Payments for Health Insurance Subsidies

Beginning in 2014, the Affordable Care Act (ACA) will make available federal subsidies to eligible individuals for the purchase of health insurance through newly created health insurance Exchanges. These subsidies are a centerpiece of the law and are designed to provide financial assistance to millions of Americans who cannot afford…

Uniform Coverage Summaries for Consumers

This brief explains the proposed federal rule that requires private health plans to provide a short, easy-to-read uniform summary of benefits and coverage to all health insurance applicants and enrollees. The rule, which implements a provision in the Affordable Care Act (ACA), is intended to make it simpler for consumers…

Health Insurance Market Reforms: Guaranteed Issue

Guaranteed issue laws require insurance companies to issue a health plan to any applicant – an individual or a group – regardless of the applicant’s health status or other factors. Currently, in most states, insurance companies can deny nongroup coverage to people based on their health status or their medical…

Quantifying the Effects of Health Insurance Rate Review

This report from the Kaiser Family Foundation analyzes the effect of government efforts to ensure that insurance premium increases are justifiable and provide value to consumers and small businesses. Rate review programs require insurers in the small group and individual markets to submit proposed rate increase requests to state or…

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…

Health Care Costs Survey – Summary and Chartpack

The summary and chartpack highlight key findings from the joint USA Today/Kaiser/Harvard School of Public Health survey exploring Americans’ views on health care costs.Survey Summary and Chartpack (.pdf)

Women’s Health Insurance Coverage

This fact sheet provides updated statistics on health coverage and describes the major sources of health insurance for non-elderly adult women ages 18–64, including employer-sponsored coverage, Medicaid, individually purchased insurance, and Medicare. It also provides data on the more than 19 million women who are uninsured, and summarizes the major implications of the health reform law for women and their health coverage.

How Non-Group Health Coverage Varies With Income

With some federal and state policy makers considering ways to encourage more people to purchase non-group, or individual, health care coverage, this new analysis by Kaiser Family Foundation researchers examines how often people at different income levels buy such coverage when they do not have access to employer coverage or…