Private Insurers Expect to Pay $1.1 Billion in Rebates This Year for Setting Premiums Too High Relative to Medical Costs May 17, 2023 News Release Private insurance companies are expecting to pay out about $1.1 billion in rebates this fall under an Affordable Care Act (ACA) 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…
Explaining Litigation Challenging the ACA’s Preventive Services Requirements: Braidwood Management Inc. v. Becerra May 15, 2023 Issue Brief This brief explains the preventive services coverage requirements, the basis of the Braidwood Management Inc. v. Becerra lawsuit, next steps in the litigation, and the potential implications.
Standardized Plans in the Health Care Marketplace: Changing Requirements May 8, 2023 Issue Brief 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.
Presentation: The End of the Public Health Emergency Declaration for COVID-19 April 26, 2023 Slideshow
Q&A: Implications of the Ruling on the ACA’s Preventive Services Requirement April 4, 2023 Blog This post summarizes some of the key issues related to the U.S. District Court’s March 30 ruling in Braidwood Management v. Becerra, which imposes new limits on the government’s ability to enforce preventive service requirements nationwide.
Increasingly Privatized Public Health Insurance Programs in the US March 30, 2023 Perspective 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.
How Do Facility Fees Contribute To Rising Emergency Department Costs? March 27, 2023 Issue Brief With the high costs of emergency department visits of significant importance to consumers and policymakers, this analysis examines claims data from privately insured individuals with large employer health plans, to examine the role that facility fees play in rising cost of emergency care.
How Have Costs Associated With Obesity Changed Over Time? March 24, 2023 Issue Brief This analysis finds that, among people with large employer health plans, those with an obesity diagnosis on average have higher total and out-of-pocket spending than those without an obesity diagnosis. It also examines the cost of common surgical and pharmacological treatments for obesity.
As the Courts Weigh the Future of the ACA’s Preventive Services Coverage, a New Analysis Shows that Most People with Private Insurance Received At Least One of Those Benefits in 2018 March 20, 2023 News Release The provision of the Affordable Care Act (ACA) that requires most private health plans to cover many preventive services without any cost-sharing for their enrollees is being challenged in federal court. The U.S. District Court in the Northern District of Texas in September concluded that aspects of the requirement were…
Preventive Services Use Among People with Private Insurance Coverage March 20, 2023 Issue Brief This analysis of claims data estimates that six in ten people with private health insurance – or about 100 million people – used at least one preventive service covered without any out-of-pocket costs through a provision of the Affordable Care Act (ACA) in a typical year prior to the COVID-19…