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Explaining Health Care Reform: Questions About Health Insurance Subsidies

To encourage broad participation in health insurance and provide affordable coverage for families, the Patient Protection and Affordable Care signed into law in March 2010 includes provisions to lower premiums and cost-sharing requirements for Americans with low and modest incomes. This brief describes the subsidies available in the law, including…

Oral Health and Low-Income Nonelderly Adults: A Review of Coverage and Access

This policy brief provides data and analysis of coverage and access to oral health care for low-income nonelderly adults. Lack of resources to pay for dental services, either through dental insurance or out-of-pocket, is a major barrier to oral health care for many low-income Americans. The problem is particularly acute…

Kaiser Survey Probes Health Insurance Brokers’ Views on Insurance Trends, ACA

A new nationally representative survey of 500 health insurance agents and brokers working in the individual and small group markets by the Kaiser Family Foundation explores their outlook on market trends and views on the Affordable Care Act (ACA). The survey finds that many agents are seeing steep increases in premiums…

Kaiser Health Security Watch

The Kaiser Health Security Watch uses Kaiser Health Tracking Poll data to measure the public’s health care-related problems and worries, including problems paying medical bills, skipping or delaying health care due to cost, and worrying about their future ability to pay for care and keep insurance. The Health Security Watch describes…

Health Insurance Market Reforms: Rate Restrictions

Rate restrictions limit how much insurance companies can vary premiums charged to individuals and businesses based on factors such as health status, age, tobacco use and gender. Currently, federal law does not place any limits on the ways that insurance companies set their premium rates. However, beginning January 1, 2014,…

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…

Quick Take: Timing Matters: States Waiting for a Supreme Court Decision to Plan an Exchange

State-based health insurance exchanges are an important component of the Patient Protection and Affordable Care Act (ACA) designed to extend subsidized private health insurance coverage to millions of Americans by 2014. Though projections show exchange enrollment could grow to 20 million individuals nationally, aggressive planning on the part of states…

Insurer Rebates under the Medical Loss Ratio: 2012 Estimates

Beginning in 2011, the Affordable Care Act (ACA) requires insurance plans to pay out a minimum percentage of premium dollars towards health care expenses and quality improvement activities, limiting the amount spent on administrative and marketing costs and profit. Under the law, large group plans are required to spend at…

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.