Data Note: 2021 Medical Loss Ratio Rebates
Private insurance companies expect to pay $2.1 billion in rebates to consumers in 2021 due to excessive premiums in recent years.
Affordable Care Act
Q1 2021 Health IT/Digital Health PC/VE, M&A, IPOs/ SPACs Activity
The first quarter of 2021 has been one of investor optimism as the vaccine rollout continues ahead of expectations and economic activity begins to accelerate in response. Within the Health IT industry, the already strong investment and M&A trends seen in 2020 have only accelerated. Over the… Read More »Q1 2021 Health IT/Digital Health PC/VE, M&A, IPOs/ SPACs Activity
Analysis Estimates 5.1 Million People Fall into the Affordable Care Act’s “Family Glitch”
A new KFF analysis estimates 5.1 million people nationally fall into the Affordable Care Act’s “family glitch” that occurs when a worker receives an offer of affordable employer coverage for themselves but not for their dependents, making them ineligible for financial assistance for marketplace coverage.… Read More »Analysis Estimates 5.1 Million People Fall into the Affordable Care Act’s “Family Glitch”
The ACA Family Glitch and Affordability of Employer Coverage
This analysis estimates that 5.1 million people fall into the Affordable Care Act’s “family glitch,” which occurs when a worker receives an offer of affordable employer coverage for themselves but not for their dependents, making them ineligible for financial assistance for marketplace coverage. It explores… Read More »The ACA Family Glitch and Affordability of Employer Coverage
Declines in Uncompensated Care Costs for The Uninsured under the ACA and Implications of Recent Growth in the Uninsured Rate
The increase in the uninsured rate in recent years, as well as loss of coverage during the pandemic, has led to attention on the consequences of being uninsured. The need for medical care to test, treat, or prevent COVID-19 has also highlighted the potential consequences… Read More »Declines in Uncompensated Care Costs for The Uninsured under the ACA and Implications of Recent Growth in the Uninsured Rate
Sources of Payment for Uncompensated Care for the Uninsured
This brief estimates the level of public funding that was paid to help offset providers’ uncompensated care costs for the uninsured in 2017. To conduct the analysis, we rely on several secondary data sources including government budget appropriations and expenditure data for major public programs… Read More »Sources of Payment for Uncompensated Care for the Uninsured
Web Briefing: Understanding the Health Coverage and Affordability Provisions in the American Rescue Plan Act
The American Rescue Plan (ARP) Act signed into law earlier this month includes a number of provisions aimed at making health coverage more accessible and affordable amid the public health and economic crises created by the COVID-19 pandemic. Join KFF at a web briefing to… Read More »Web Briefing: Understanding the Health Coverage and Affordability Provisions in the American Rescue Plan Act
How the American Rescue Plan Act Affects Subsidies for Marketplace Shoppers and People Who Are Uninsured
This brief use data from the American Community Survey (ACS) to provide estimates of eligibility for and the amount of financial assistance to purchase Marketplace coverage under the ARPA among both current individual market purchasers, as well as Marketplace-eligible uninsured people.
Impact of Key Provisions of the American Rescue Plan Act of 2021 COVID-19 Relief on Marketplace Premiums
This data note estimates how tax credits premiums will change for people at various ages and incomes under the temporary boost in subsidies included in the American Rescue Plan Act of 2021, the COVID-19 relief plan signed into law in March 2021.
Updated KFF Calculator Estimates Marketplace Premiums to Reflect Expanded Tax Credits in COVID-19 Relief Legislation
KFF has updated its 2021 Health Insurance Marketplace Calculator to reflect the expanded premium tax credits available to people who purchase their own coverage through their state’s health insurance exchange as passed by Congress in the American Rescue Plan Act and expected to be signed… Read More »Updated KFF Calculator Estimates Marketplace Premiums to Reflect Expanded Tax Credits in COVID-19 Relief Legislation
Payers Struggle with Provider Data Management Too
Eric Demers, CEO of Madaket Health Provider data management is usually discussed from the provider perspective: the busy staff, the needless paperwork amid a pandemic, the faxing, emailing and uploading of data. In these scenarios, the health plans are often painted as the villains for… Read More »Payers Struggle with Provider Data Management Too
KFF Tracking Poll: More Than a Third of Americans Say They’ve Struggled to Pay Living Expenses Since December; 6 in 10 Families Hit by COVID Have Lost A Job or Income
Majorities Favor Provisions to Expand Marketplace Tax Credits and Encourage States to Expand Medicaid As Congress considers an additional $1.9 trillion COVID-19 relief plan, more than a third (37%) of Americans say that someone in their household has had trouble paying basic living expenses over… Read More »KFF Tracking Poll: More Than a Third of Americans Say They’ve Struggled to Pay Living Expenses Since December; 6 in 10 Families Hit by COVID Have Lost A Job or Income
KFF Health Tracking Poll: Economic Hardship, Health Coverage, And The ACA
This poll examines the public’s assessments of the Biden administration’s handling of the coronavirus pandemic, the impact COVID-19 has had on people’s finances, and support for provisions of the latest COVID-19 relief bill. It examines the public’s views of the ACA and possible next steps.
Survey: OBGYNs Report That the Affordable Care Act Has Increased Use of Contraceptives Among Patients, but the Cost of Reproductive Health Care Still a Burden for Their Low-Income Patients
This report highlights key findings from the 2020 KFF National Physician Survey on Reproductive Health that asked a nationally representative sample of OBGYNs practicing in the United States about a wide range of issues, including their provision of contraception, abortion, and STI care.
OBGYNs and the Provision of Sexual and Reproductive Health Care: Key Findings from a National Survey
This report highlights key findings from the 2020 KFF National Physician Survey on Reproductive Health that asked a nationally representative sample of OBGYNs practicing in the United States about a wide range of issues, including their provision of contraception, abortion, and STI care.
Two New Analyses: House COVID-19 Relief Plan Would Temporarily Lower Marketplace Premiums for Millions and More than Offset Short-Term State Costs to Expand Their Medicaid Programs
The House COVID-19 relief proposal would temporarily lower what millions of Marketplace enrollees and uninsured potential enrollees would pay toward premiums and would provide states that have not expanded their Medicaid programs a financial boost that would more than offset their costs initially, two new… Read More »Two New Analyses: House COVID-19 Relief Plan Would Temporarily Lower Marketplace Premiums for Millions and More than Offset Short-Term State Costs to Expand Their Medicaid Programs
Impact of Key Provisions of the House COVID-19 Relief Proposal on Marketplace Premiums
This data note estimates how premiums would change for people at various ages and incomes under the subsidy schedule outlined in the House COVID-19 Relief Proposal.
New White House, Covid-19 pandemic spurring insurer participation in ACA marketplace
Insurer participation in the ACA individual marketplace is on the rise and the trend is driven by policy changes at the federal level and the lingering effects of the Covid-19 pandemic.
Kathleen Sebelius at Health Datapalooza: To push ACA forward, forget bipartisanship
At a Health Datapalooza session, former HHS head Kathleen Sebelius looked back on lessons learned in 2009 when the Affordable Care Act was moving through Congress. She cautioned the Biden administration against leaning on bipartisanship when restoring the healthcare law.
ACA Open Enrollment Matters for Medicaid Coverage, Too
President Biden’s January 28th executive order to reopen enrollment in the federal ACA Marketplace from February 15 through May 15, combined with $50 million in federal spending on outreach and education about ACA coverage options, has the potential to reach millions of people who were… Read More »ACA Open Enrollment Matters for Medicaid Coverage, Too
Nearly 9 Million Uninsured Americans Could Get Free or Subsidized Health Insurance if the Biden Administration Re-Opens ACA Marketplace Enrollment in Response to COVID-19
Four million uninsured people could get an ACA bronze plan with no premium payment and 4.9 million others could get subsidies to offset the cost of such a plan if the Biden Administration were to re-open ACA marketplace enrollment, a KFF analysis finds. Four million… Read More »Nearly 9 Million Uninsured Americans Could Get Free or Subsidized Health Insurance if the Biden Administration Re-Opens ACA Marketplace Enrollment in Response to COVID-19
Marketplace Eligibility Among the Uninsured: Implications for a Broadened Enrollment Period and ACA Outreach
In this analysis, we examine key demographic characteristics of the uninsured eligible to buy Marketplace coverage, estimating the numbers of people who might benefit from an SEP and how outreach activities might be best targeted.
The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid
In states that do not implement the Medicaid expansion under the Affordable Care Act (ACA), many adults will fall into a “coverage gap” of earning too much to qualify for Medicaid but not enough to qualify for Marketplace premium tax credits. Nationwide, 2.2 million poor… Read More »The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid
Claims Denials and Appeals in ACA Marketplace Plans
Based on an analysis of transparency data released by the Centers for Medicare and Medicaid Services (CMS), this brief assess claims denials and appeals among issuers offering individual market coverage on healthcare.gov and finds that 17% of in-network claims were denied by issuers in 2019,… Read More »Claims Denials and Appeals in ACA Marketplace Plans
Women’s Health Insurance Coverage
This factsheet reviews major sources of coverage for women residing in the U.S. in 2019, discusses the impact of the ACA on women’s coverage, and the coverage challenges that many women continue to face
Medicaid Expansion Enrollment and Spending Leading up to the COVID-19 Pandemic
This issue brief analyzes enrollment and spending trends related to the Affordable Care Act’s Medicaid expansion ahead of the coronavirus pandemic and examines potential consequences of recent enrollment increases.
Joe Biden’s New Health Care Agenda (and CMS’s Big Role In It)
With the Georgia runoff elections giving Democrats control of the U.S. Senate, Drew Altman discusses President-elect Biden’s potential health care agenda and suggests that the Centers for Medicare & Medicaid Services could have an expanded role and that it may be time to rename it… Read More »Joe Biden’s New Health Care Agenda (and CMS’s Big Role In It)
5 Targeted Actions a Biden Administration Could Use to Expand Medicaid Coverage
The recent election of former Vice President Joe Biden as well as the on-going effects of the coronavirus pandemic and related economic downturn are the key issues that will substantially shape Medicaid policy over the next year.
Poll: Large Majorities Now Say They Wear Masks Regularly and Can Continue Social Distancing for At Least Six Months if Needed, though Republicans Remain Less Likely to Take Such Precautions
As winter sets in and COVID-19 cases and deaths reach records in most parts of the country, more Americans say they wear masks every time they leave home now (73%) than said so in May (52%), a new KFF Health Tracking Poll finds. A small… Read More »Poll: Large Majorities Now Say They Wear Masks Regularly and Can Continue Social Distancing for At Least Six Months if Needed, though Republicans Remain Less Likely to Take Such Precautions
Health Insurer Financial Performance Through September 2020
In this brief, we analyze third quarter data from 2018 to 2020 to examine how insurance markets performed financially through the end of September. Average margins remained relatively high compared to the same point in recent years, suggesting many insurers remained profitable even as non-COVID-related… Read More »Health Insurer Financial Performance Through September 2020
How Has the Pandemic Affected Health Coverage in the U.S.?
Findings from administrative data suggest that the decline in enrollment among employer-sponsored insurance was far less than overall declines in employment as of September, and that many who did lose their job-based coverage likely found a safety net in coverage through Medicaid or the ACA… Read More »How Has the Pandemic Affected Health Coverage in the U.S.?
Potential Health Policy Administrative Actions Under President Biden
This brief outlines the potential health policy actions that President Biden could take using executive authority, based on campaign pledges, and actions that would reverse or modify regulations or guidance issued by the Trump Administration.
Preventive Services Tracker
The Affordable Care Act (ACA) requires new private health insurance plans to cover many recommended preventive services without any patient cost-sharing. This tracker presents up-to-date information on the adult preventive services nongrandfathered private plans must cover, by condition, including a summary of the recommendation, the… Read More »Preventive Services Tracker
New study ties pharma payments to prescription practices
Recent efforts to improve transparency haven’t made much of a difference, one author noted. But earlier reforms made a dent the “most egregious” practices.
Millions of Uninsured Americans are Eligible for Free ACA Health Insurance
Amid the ongoing pandemic and high unemployment, this poste xamines how many uninsured people would be eligible for free health insurance during in a typical year, including those who qualify for Medicaid or for tax credits that cover the full cost of an ACA Marketplace… Read More »Millions of Uninsured Americans are Eligible for Free ACA Health Insurance
Insurer Participation on the ACA Marketplaces, 2014-2021
For the third straight year, more insurers are entering the ACA Marketplaces or expanding their service area in 2021, creating more choices for consumers shopping for coverage during the 2021 open enrollment period.
How ACA Marketplace Premiums Are Changing by County in 2021
Premiums for ACA Marketplace benchmark silver plans are decreasing on average across the U.S. in 2021. However, premium changes vary widely by location and by metal level, including premium increases in a number of counties and plans.
Supreme Court justices seem unlikely to axe the ACA
Now with a 6-3 conservative majority, the nation’s highest court still seems reticent to throw out the Affordable Care Act altogether. If the law stays in place, it would be the foundation for many of President-elect Biden’s planned healthcare policies.
Key Facts about the Uninsured Population
This issue brief describes trends in health coverage prior to the pandemic, examines the characteristics of the uninsured population in 2019, and summarizes the access and financial implications of not having coverage.
10 Reasons to Pay Attention to ACA Open Enrollment This Year
Whether new to the market or reenrolling, everyone who wants 2021 coverage through the ACA Marketplace must sign up during Open Enrollment. Here, we detail ten ways in which the 2021 ACA open enrollment period differs from enrollment periods in past years.
People with Disabilities Are At Risk of Losing Medicaid Coverage Without the ACA Expansion
This data note presents the latest state-level data about nonelderly Medicaid adults who have disabilities but do not quality for SSI and considers the implications for their continued coverage if the ACA expansion is invalidated by the Court.
A Conundrum: Majority of Republican Voters Want to Overturn ACA but Keep Protections for People with Pre-existing Conditions
This post examines the implications of Republican voters wanting the Supreme Court to overturn the entire Affordable Care Act, but not the law’s protections for people with pre-existing conditions.
Tracking Section 1332 State Innovation Waivers
This interactive map shows the status of all Section 1332 waivers requested by states. The Affordable Care Act (ACA) allows states to apply for innovation waivers to alter key ACA requirements in the individual and small group insurance markets and can be used to shore… Read More »Tracking Section 1332 State Innovation Waivers
The Landscape of Medicaid Demonstration Waivers Ahead of the 2020 Election
As the Trump administration reaches the end of its first term, this issue brief considers the landscape of approved and pending Section 1115 Medicaid demonstration waivers under this administration and how the November 2020 presidential election may impact this landscape.
Explaining Health Care Reform: Questions About Health Insurance Subsidies
This brief describes health insurance subsidies available through the Affordable Care Act’s marketplaces, including premium subsidies that would be provided in the form of tax credits, as well as other subsidies that would lower cost sharing to eligible Americans. It provides details on who is… Read More »Explaining Health Care Reform: Questions About Health Insurance Subsidies
Loss of the ACA Could Greatly Erode Health Coverage and Benefits for Women
This brief examines what the loss of the Affordable Care Act (ACA) would mean for women’s coverage and access to health care.
COVID-19 Pandemic Further Exposes Systemic Racism…
Michael A Greely, Co-Founder & General Partner at Flare Capital Partners This will be ugly and sad. Racism has cost this country $16 trillion over the last twenty years according to a recent Citigroup report. Much of this loss ($13 trillion) was attributed to discriminatory lending… Read More »COVID-19 Pandemic Further Exposes Systemic Racism…
What Happens to Medicaid Drug Policy if the ACA is Overturned?
The repeal of the ACA could mean loss of Medicaid coverage for up to 15 million that were enrolled in the ACA Medicaid expansion group prior to the COVID-19 pandemic; however, repeal could also mean significant changes to Medicaid prescription drug policy with implications for… Read More »What Happens to Medicaid Drug Policy if the ACA is Overturned?
Rural Hospital Execs Can Beat COVID-19 By Shifting From Reactive to Proactive Care
Eric Tran, Tulane School of Medicine Donald Voltz, MD, Aultman Hospital The COVID-19 virus is ravaging the planet at a scale not seen since the infamous Spanish Flu of the early 1900s, inflicting immense devastation as the U.S. loses more than 200,000 lives and counting.… Read More »Rural Hospital Execs Can Beat COVID-19 By Shifting From Reactive to Proactive Care
Want to protect people with preexisting conditions? You need the full Affordable Care Act.
In this perspective published by the Washington Post, KFF Executive Vice President for Health Policy Larry Levitt explains why the popular Affordable Care Act provisions that ensure people with pre-existing conditions can access affordable health insurance can’t easily be preserved if other related provisions are… Read More »Want to protect people with preexisting conditions? You need the full Affordable Care Act.
Careful What You Wish For: How Republican Attorneys General’s Attack on the ACA Could Trigger Medicare for All
By MIKE MAGEE Cautionary tales are timeless. Take for example Aesop’s Fables, from 620 BC, which included the advisory, “Be careful what you wish for lest it come true.” Trump and the Republicans who oppose the ACA take heed. You may be inadvertently taking the… Read More »Careful What You Wish For: How Republican Attorneys General’s Attack on the ACA Could Trigger Medicare for All
Health Policy Resources for Covering the 2020 Elections
As the 2020 Election Day approaches, many candidates continue to focus on health care issues, including on the public health and economic response to COVID-19, the future of the Affordable Care Act, health care costs and abortion. To help reporters understand and cover these issues,… Read More »Health Policy Resources for Covering the 2020 Elections
Demographics, Insurance Coverage, and Access to Care among Transgender Adults
This analysis seeks to better understand the experiences of transgender people in the US health care system. We examine the demographic characteristics of transgender adults ages 18 and over and their access to health care and insurance coverage.
Joe Biden’s Big Lead on Health Care Issues
In an Axios column, Drew Altman discusses how this election year health isn’t a single issue — but several — and Joe Biden has the edge over President Trump on all of them, even as opposition to the ACA remains popular with Trump’s base.
2021 Premium Changes on ACA Exchanges and the Impact of COVID-19 on Rates
A look at preliminary marketplace rate filings reveals many premium changes for 2021 are moderate thus far, with increases or decreases of a few percentage points. However, most insurers have not yet incorporated the rate impacts of the COVID-19 pandemic in their rate changes for… Read More »2021 Premium Changes on ACA Exchanges and the Impact of COVID-19 on Rates
Medicaid Covers People with Pre-Existing Conditions, Too
In recent weeks, the possible overturning of the Affordable Care Act (ACA) in court and the upcoming election have focused attention on the issue of protections for people with pre-existing conditions. While the focus has been on the ACA’s private insurance protections, Medicaid also plays… Read More »Medicaid Covers People with Pre-Existing Conditions, Too
KFF Health Tracking Poll – October 2020: The Future of the ACA and Biden’s Advantage On Health Care
The poll examines the public’s views on the Supreme Court case to overturn the Affordable Care Act and its protections for people with pre-existing conditions. Less than a month from the results of the 2020 presidential election, this poll examines the top issues for voters… Read More »KFF Health Tracking Poll – October 2020: The Future of the ACA and Biden’s Advantage On Health Care
5 Charts About Public Opinion on the Affordable Care Act and the Supreme Court
This compiles key polling data examining the favorability of the Affordable Care Act and its provisions, including protections for people with pre-existing conditions.
A Reconfigured U.S. Supreme Court: Implications for Health Policy
U.S. Supreme Court decisions shape health policy in important ways. The nomination of Judge Amy Coney Barrett, if confirmed, is expected to establish a solid 6:3 conservative majority that could affect case outcomes in several areas. This issue brief considers the potential implications of a… Read More »A Reconfigured U.S. Supreme Court: Implications for Health Policy
Mental Illness May Soon Be the Most Common Pre-Existing Conditions
Because the prevalence of depression and anxiety disorders appears to have increased substantially since the start of the Coronavirus pandemic, if the ACA is repealed, mental illnesses could be the most common pre-existing conditions.
Health Care and the 2020 Presidential Election
This side-by-side comparison examines President Trump’s record and former Vice President Biden’s positions across a wide range of key health issues, including the response to the pandemic, the Affordable Care Act marketplace, Medicaid, Medicare, drug prices, reproductive health, mental health and opioids, immigration and health… Read More »Health Care and the 2020 Presidential Election
Protecting People With Pre-Existing Conditions Isn’t As Easy As It Seems
With the death of Justice Ruth Bader Ginsburg, a lawsuit before the Supreme Court to overturn the Affordable Care Act (ACA) suddenly has a much better chance of succeeding. And, that could make protections for people with pre-existing conditions an even bigger campaign issue.
Contraception X Article: Out-of-Pocket Spending for Oral Contraceptives Among Women with Private Insurance Coverage After the Affordable Care Act
In an article for Contraception X, KFF’s Brittni Frederiksen, Matthew Rae, and Alina Salganicoff examine large employer plans to identify which types and brands of oral contraceptive pills have the largest shares of oral contraceptive users with out-of-pocket spending and which oral contraceptives have the… Read More »Contraception X Article: Out-of-Pocket Spending for Oral Contraceptives Among Women with Private Insurance Coverage After the Affordable Care Act
District judge blocks HHS rule that would end transgender health protections
A U.S. district judge blocked a rule by the Department of Health and Human Services that would end anti-discrimination provisions protecting transgender patients. In his decision, U.S. District Judge Frederic Block said that the rule violated a recent Supreme Court decision protecting LGBTQ workers’ rights.
KFF Health Tracking Poll: The Public’s Views on the ACA
This interactive chart allows users to track public opinion on the Affordable Care Act, from the inception of the law to the present, for subgroups based on age, race, income, gender, party identification and insurance status.
An Early Look at 2021 Premium Changes on ACA Exchanges and the Impact of COVID-19 on Rates
A look at preliminary marketplace rate filings reveals many premium changes for 2021 are moderate thus far, with increases or decreases of a few percentage points. However, most insurers have not yet incorporated the rate impacts of the COVID-19 pandemic in their rate changes for… Read More »An Early Look at 2021 Premium Changes on ACA Exchanges and the Impact of COVID-19 on Rates
Individual Insurance Market Performance in Early 2020
Individual market insurers, on average, remained profitable through the first three months of 2020 as claims costs rose only slightly compared to the same period last year. It is likely that the most significant impacts of the coronavirus on the individual market will not be… Read More »Individual Insurance Market Performance in Early 2020
Insurance Coverage and Viral Suppression Among People with HIV in the United States, 2015-2018
Health insurance coverage and access to care improve health outcomes, including viral suppression, for people with HIV in the United States. Prior research has demonstrated that implementation of the Affordable Care Act (ACA) in 2014 increased coverage among people with HIV and that certain forms… Read More »Insurance Coverage and Viral Suppression Among People with HIV in the United States, 2015-2018
How Threatening The ACA Again Could Hurt Trump With Independent Voters
In his Axios column, Drew Altman shows how threatening the Affordable Care Act in the U.S. Supreme Court, or overturning it, could hurt President Trump with independent voters, and says that could matter most in battleground states.
Status of State Medicaid Expansion Decisions: Interactive Map
This page displays an interactive map of the current status of state decisions on the Affordable Care Act’s Medicaid expansion. Additional Medicaid expansion resources are listed (with links) below the map.