Marketplaces

The Health Insurance Marketplace Calculator, updated with 2023 premium data, provides estimates of health insurance premiums and subsidies for people purchasing insurance on their own in health insurance exchanges (or “Marketplaces”) created by the Affordable Care Act (ACA).

This survey of Marketplace assister programs and brokers tracks the experiences of professionals signing people up for Affordable Care Act coverage. It also examines the role that these programs expect to play when the COVID-19 public health emergency (PHE) ends, potentially ending Medicaid eligibility for millions of Medicaid enrollees.

As part of the Inflation Reduction Act, the Senate recently passed a three-year extension (through 2025) of enhanced subsidies for people buying their own health coverage on the Affordable Care Act Marketplaces. The enhanced subsidies increase the amount of financial help available to those already eligible and also newly expand subsidies to middle-income people, many of whom were previously priced out of coverage. Here’s what to know about the likely renewal of these subsidies:

Healthcare.gov marketplace insurers denied nearly one out of every five claims (18%) submitted for in-network services in 2020, though why the denial rates are so high and the ultimate consequences for consumers are difficult to access from the publicly available data, a new KFF analysis finds. The Affordable Care Act…

The Health Insurance Marketplace Calculator, updated with 2022 premium data, provides estimates of health insurance premiums and subsidies for people purchasing insurance on their own in health insurance exchanges (or “Marketplaces”) created by the Affordable Care Act (ACA).

In this column for the JAMA Health Forum, Larry Levitt highlights four changes implemented during the COVID-19 pandemic that helped to make health care more accessible and affordable and the prospects for those changes to telehealth, COVID-19 coverage, Medicaid and marketplace premiums continuing beyond the pandemic’s end.

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.

Data from the KFF Employer Health Benefits Survey demonstrates that some workers face very high contribution amounts for family coverage, including 12% who would have pay at least $10,000 annually in premiums for a family of four. These are the workers most likely to benefit from a fix to the ‘family glitch’.

Continuous enrollment in Medicaid and enhanced premium assistance have helped millions afford and maintain coverage, but those gains could be reversed as the public emergency ends and if the provisions like those in the Build Back Better Act fail to pass.

Health plan networks affect patient access to care. This brief reviews options for setting and enforcing network adequacy standards and tools for making differences in plan networks more transparent.