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.
Private Insurers Expect to Pay $1 Billion in Rebates to Consumers This Year for Setting Premiums Too High Relative to Medical Costs June 1, 2022 News Release Private insurance companies are expecting to pay out $1 billion in rebates to consumers this fall under an Affordable Care Act provision that requires insurers to spend the bulk of customers’ premium payments on care, a new KFF analysis finds. Rebates are based on insurers’ experiences over the previous three…
Claims Denials and Appeals in ACA Marketplace Plans in 2021 February 9, 2023 Issue Brief 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.
Falling off the Subsidy Cliff: How ACA Premiums Would Change for People Losing Rescue Plan Subsidies June 30, 2022 Blog This post examines what would happen to ACA marketplace premiums for enrollees with incomes more than four times the federal policy level if the enhanced American Rescue Plan Act subsidies expire, including variations by state .
Marketplace Insurers Denied Nearly 1 in 5 In-Network Claims in 2020, though It’s Often Not Clear Why July 5, 2022 News Release 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…
ACA’s Maximum Out-of-Pocket Limit Is Growing Faster Than Wages July 20, 2022 Issue Brief This analysis finds that the ACA’s maximum out-of-pocket limit is likely to grow faster than wages and salaries, and is also expected to grow faster than the maximum out-of-pocket limit for Health Savings Account (HSA)-qualified health plans.
August 11 Web Event: Understanding the Health Care Provisions in the Inflation Reduction Act August 11, 2022 Event The Inflation Reduction Act includes several landmark health care provisions that would lower prescription drug costs for people with Medicare, reduce Medicare drug spending and extend enhanced subsidies for Affordable Care Act marketplace coverage. On Thursday, August 11, a panel of KFF experts held a web briefing to explain these…
Five Things to Know about the Renewal of Extra Affordable Care Act Subsidies in the Inflation Reduction Act August 11, 2022 Blog 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:
The Biggest Health Care Reform in a Decade Could Lower Your Costs August 13, 2022 Perspective Larry Levitt writes about the political and practical impact of the health care provisions in the Inflation Reduction Act in The New York Times guest essay, “The Biggest Health Care Reform in a Decade Could Lower Your Costs.”
August 24 Web Event: Health Care Inflation in the U.S. August 24, 2022 Event As the 2022 mid-term elections approach, inflation and gas prices are on the top of voters’ minds. While health care prices have often risen faster than the rest of the economy, the prices for medical services are generally set in advance – often tied to the calendar year – creating…