Small Area Variations and the ACA’s Coverage Expansions March 6, 2012 Perspective A new Kaiser analysis sheds light on how the country might react to the Affordable Care Act (ACA) when it is implemented. It looks at how the benefits of the ACA’s coverage expansions will vary around the country by census areas (technically, Public Use Microdata Areas, or PUMAs). PUMAs are…
What the Actuarial Values in the Affordable Care Act Mean April 1, 2011 Issue Brief The Patient Protection and Affordable Care Act (PPACA) establishes four levels of coverage based on the concept of “actuarial value,” which represents the share of health care expenses the plan covers for a typical group of enrollees. As plans increase in actuarial value – bronze, silver, gold, and platinum –…
Private Insurance Benefits and Cost-Sharing Under the ACA February 28, 2012 Perspective The Department of Health and Human Services (HHS) recently released guidance on the two key components that determine the level of protection that private insurance plans will provide to consumers under health reform. The first involves the services that insurance plans must cover, and the second involves how much patients…
Health Insurance Transparency under the Affordable Care Act March 8, 2012 Perspective In February, a final rule was issued implementing the Affordable Care Act (ACA) requirement that all health plans provide a uniform summary of coverage for all enrollees and applicants. The idea of providing easy-to-understand summaries of coverage is, in fact, the most popular provision in the ACA, according to a recent Kaiser…
The ACA and Fluoridation: The Power of Political Symbols March 14, 2012 Perspective In the 1950s, water fluoridation became a public health controversy that morphed into a symbolic issue of larger proportions. For its opponents, fluoridation came to symbolize big government and even for some, a communist threat. The controversy became so odd that it was parodied in Stanley Kubrick’s 1964 film “Dr.…
Explaining Health Reform: How will the Affordable Care Act affect Small Businesses and their Employees? January 1, 2012 Fact Sheet Several provisions of the Affordable Care Act (ACA) will likely have significant effects on small businesses, their employees, and families. Currently, smaller businesses are less likely to offer health insurance coverage to their employees than larger companies: 57% of small businesses with 50 or fewer workers offered health benefits to…
Quick Take: Key Considerations in Evaluating the ACA Medicaid Expansion for States April 18, 2013 Fact Sheet A central goal of the Patient Protection and Affordable Care Act (ACA) is to significantly reduce the number of uninsured by providing a continuum of affordable coverage options through Medicaid and new Health Insurance Exchanges. Following the June 2012 Supreme Court decision, states face a decision about whether to adopt…
Explaining Health Care Reform: Medical Loss Ratio (MLR) February 29, 2012 Fact Sheet 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.
Beyond Rebates: How Much Are Consumers Saving from the ACA’s Medical Loss Ratio Provision? June 6, 2013 Perspective The Medical Loss Ratio (MLR) provision of the Affordable Care Act (ACA) saved consumers an estimated $2.1 billion last year, in the form of lower premiums and rebates, according to a new analysis by the Kaiser Family Foundation. Under health reform, insurers must issue consumer rebates if they fail to spend a certain portion of premium income on health care claims and quality improvement expenses, thereby limiting what they may spend on administrative expenses or keep as profits.
How Buying Insurance Will Change Under Obamacare September 24, 2013 Perspective When the Affordable Care Act’s (ACA) health insurance marketplaces (also known as “exchanges”) go online this October, millions of people are expected to apply for private insurance coverage. Nobody expects the launch will be perfect, with no hitches and problems. The law not only replaces a fragmented and confusing assortment…