Consumer Protection

Most (58%) people with health insurance say they encountered at least one problem using their coverage in the past year, with even larger shares of people with the greatest health care needs reporting such problems, finds a new KFF survey of consumer experiences with health insurance. Such problems vary across…

This brief examines the evolving requirements for insurers on HealthCare.gov to offer standardized plans that follow set cost sharing rules for covered benefits in addition to other plans they might offer. It also reviews how some state-run marketplaces have used standardized plans to limit cost sharing for insulin, mental health care, and other services.

In this JAMA Forum column, KFF’s Larry Levitt examines the growing role of private insurance companies in public programs, including Medicare Advantage and Medicaid managed care, and the tradeoffs that result.

This brief explains a new proposed federal regulation aimed at reducing administrative hassles involved in obtaining prior authorization for care and sets out key policy questions, including how the proposal could impact the patient experience and data privacy.

Since 2021, federal law has required hospitals to publicly post information about their standard prices and negotiated discount rates for common health services to encourage consumers to compare prices and to promote competition. To date, however, the transparency data currently shared by hospitals to comply with the law are messy,…

This analysis examines transparency data currently shared by hospitals to comply with federal law and finds that they are messy, inconsistent and confusing, making it challenging if not impossible for patients or researchers to use them to compare prices. Many of these shortcomings stem from a lack of specificity in the requirements for what hospitals must report.

This analysis of HealthCare.gov Marketplace insurers’ transparency data finds that 17% of in-network claims were denied in 2021, with denial rates varying widely across insurers. Consumers appealed less than two-tenths of 1% of denied in-network claims.

With federal agencies preparing to update parity regulations and Congress considering reforms, our new report explains existing parity requirements, including who they apply to and how their enforced, and highlights key policy issues raised by regulators and advocates that could be addressed in the future. Those issues include: Simplifying parity standards…

This brief discusses federal mental health parity protections — what they are, who they apply to, who enforces them and key policy issues as Congress and federal agencies evaluate improvements to the law to address gaps in mental health coverage and access.

Most (53%) adults with health care debt say they have received a medical or dental bill they thought contained an error at some point in the past 5 years, and most say a state consumer assistance program would be helpful to them.