Consumer Protection

This issue brief examines states’ approaches to administering wrap-around benefits and cost-sharing in long-standing Medicaid premium assistance programs and the information available to beneficiaries about how to access these program features.

A new Kaiser Family Foundation survey of insurance brokers and assistance programs examines the help they provided to consumers during the 2015 open enrollment period for Affordable Care Act coverage. The 2015 Survey of Health Insurance Marketplace Assister Programs and Brokers provides estimates of the number of people helped and…

This nationwide survey analysis of Marketplace consumer assistance programs and brokers examines the nature of Marketplace assistance during the second open enrollment period for 2015 coverage, and offers unique insights into how Affordable Care Act (ACA) implementation is progressing, what is changing, and what challenges remain. Building upon our Survey of Health Insurance Marketplace Assister Programs (2014), the analysis compares Assister Program capacity and experiences from the first open enrollment period to the next, and also includes the enrollment experience of brokers for the first time.

This report examines similarities and differences in federal consumer protection standards for Medicare Advantage (MA) plans, Qualified Health Plans (QHPs), and Medicaid Managed Care Organizations (MCOs). It focuses on rules established at the federal level, though some states have chosen to go above the federal minimums and impose additional requirements for QHPs and Medicaid MCOs.

In this five-minute animated video, the YouToons help consumers understand their health insurance through fun, easy-to-understand explanations and scenarios. This cartoon serves as a tutorial for consumers and organizations. The YouToons previously appeared in the 2010 animated movie, “Health Reform Hits Main Street” and the 2013, “The YouToons Get Ready for Obamacare: Health Insurance Changes Coming Your Way Under the Affordable Care Act.”

This issue brief analyzes key themes in 19 capitated § 1115 and § 1915(b)/(c) Medicaid managed long-term services and supports (MLTSS) waivers approved to date by the Centers for Medicare and Medicaid Services (CMS) with a focus on covered populations and services, provisions aimed at expanding beneficiary access to HCBS, beneficiary protections, and quality measurement and oversight.

An updated fact sheet from the Kaiser Family Foundation summarizes the latest information on health plan coverage of preventive services under the Affordable Care Act. The fact sheet details the rules that govern when plans are required to cover services without cost-sharing and which services are covered. In addition, the…

This brief highlights the experiences of Navigators and other Marketplace consumer assistance programs under the Affordable Care Act (Obamacare) in conducting outreach and providing enrollment assistance during the ACA’s first open enrollment period. It provides insight into the outreach and enrollment strategies the assisters developed and identifies the keys to successfully overcoming the challenges of the first year. These insights are based on findings from focus groups with assisters in four cities: Miami, Florida; Houston, Texas; Raleigh, North Carolina; and Cleveland, Ohio.

Larry Levitt’s July 2014 post at the JAMA Forum assesses early indications of how well the Affordable Care Act is working.