Examining Prior Authorization in Health Insurance May 20, 2022 Blog This post explains what’s known about how insurers use prior authorization as a tool to control costs and encourage cost-effective care, the state and federal laws that govern it, and ongoing policy debates over efforts to impose standards to limit or regulate its use.
For ACA Enrollees, How Much Premiums Rise Next Year is Mostly up to Congress May 18, 2022 Blog Most customers with coverage through Affordable Care Act’s marketplaces will face big premium increases next year if Congress doesn’t extend the temporary enhanced tax credits included in the American Rescue Plan Act (ARPA) of 2021. If the outcome isn’t clear by summer, fall open enrollment could be a mess.
May 23 Web Event: Executive Actions to Address Prescription Drug Affordability in the U.S. May 23, 2022 Event U.S. prescription drug spending per person is about double what it is in peer countries and about 8 in 10 U.S. adults say the cost of prescription drugs is unreasonable. With the public ranking lowering out-of-pocket costs for prescription drugs the top health care priority for Congress, lawmakers have been…
Employer Coverage of Travel Costs for Out-of-State Abortion May 16, 2022 Blog This Policy Watch gives an overview of employers offering to cover travel expenses for workers who need to go out of state for an abortion in the context of increasing restrictions on abortion around the country. We discuss who is offering these benefits, the implications for workers, and some of the legal and political concerns for employers.
State Actions to Protect and Expand Access to Abortion Services May 16, 2022 Issue Brief This brief reviews the status of state actions to strengthen and guarantee abortion access to their residents, as well as to prepare for the likely increase in demand for abortion services in those states should the high court overturn the constitutional right to abortion established by Roe v. Wade.
Unwinding the PHE: What We Can Learn From Pre-Pandemic Enrollment Patterns May 10, 2022 Issue Brief This brief examines typical enrollment patterns for Medicaid and CHIP and uses 2018 Medicaid claims data to gain insight into the effects of the continuous enrollment requirements by eligibility group. Roughly 2% of Medicaid enrollees come on or leave the program in an average month, although there is variation across eligibility groups. A policy to require continuous enrollment would result in sharp reductions in monthly disenrollment rates and would also reduce monthly enrollment rates due to reductions in churn.
2022 Changes to the Public Charge Inadmissibility Rule and the Implications for Health Care May 5, 2022 Issue Brief This brief provides background on public charge, describes the 2019 policy changes and their chilling effects, and reviews provisions of the 2022 public charge rule and its implications for immigrants’ access to health care.
Kaye Pestaina April 18, 2022 Person Kaye Pestaina is a vice president at KFF, where she directs its Program on Patient and Consumer Protections. She has more than 25 years of experience in health law and policy, as well as employee benefits law. Prior to joining KFF, Pestaina was a principal in Mercer’s Government and Human…
Help with Medicare Premium and Cost-Sharing Assistance Varies by State April 20, 2022 Issue Brief This data note provides an overview of programs that help beneficiaries with modest incomes with their Medicare costs, including the Medicare Savings Programs and the Part D Low-Income Subsidy, and highlights findings from corresponding state-level profiles of eligibility and enrollment.