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Falling off the Subsidy Cliff: How ACA Premiums Would Change for People Losing Rescue Plan Subsidies

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 .

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KFF’s Kaiser Health News and NPR Launch Diagnosis: Debt, a Yearlong Reporting Partnership Exploring the Scale, Impact, and Causes of the Health Care Debt Crisis in America

KFF’s Kaiser Health News (KHN) and NPR today launched a yearlong investigative project that explores the scale, impact, and causes of the health care debt crisis in the United States. Drawing upon a special KFF poll conducted for the project, original data analysis, and hundreds of interviews, the investigation reveals a problem far more pervasive…More

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Health Care Debt In The U.S.: The Broad Consequences Of Medical And Dental Bills

The KFF Health Care Debt Survey finds that four in ten adults have some form of health care debt, with most citing one-time or short-term medical expenses as the contributor. Many of those with health care debt report making personal sacrifices and enduring financial consequences as a result of their debt, while nearly one in five think they will never be able to pay off.

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Overall inflation has not yet flowed through to the health sector

Prices for medical services typically rise more quickly than the broader economy, but the reverse has been true recently as general inflation rose rapidly. The recent trend reflects the unusually high inflation affecting other parts of the economy, which could bleed over to affect health care costs at some point.

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Data Note: 2022 Medical Loss Ratio Rebates

We find that insurers estimate they will issue a total of about $1 billion in Medical Loss Ratio (MLR) rebates this year across all commercial markets under a provision of the Affordable Care Act (ACA) that limits the share of premiums that insurers can keep for administration, marketing, and profits.

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Private Insurers Expect to Pay $1 Billion in Rebates to Consumers This Year for Setting Premiums Too High Relative to Medical Costs

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 years. This year’s total is…More

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Price Regulation, Global Budgets, and Spending Targets: A Road Map to Reduce Health Care Spending, and Improve Affordability

We review several policy options to constrain health care spending, primarily by putting downward pressure on provider prices, including price regulation, global budgets, and spending growth targets.

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May 23 Web Event: Executive Actions to Address Prescription Drug Affordability in the U.S.

U.S. prescription drug spending per person is about double what it is in peer countries and about 8 in 10 U.S. adults say the cost of prescription drugs is unreasonable. With the public ranking lowering out-of-pocket costs for prescription drugs the top health care priority for Congress, lawmakers have been debating legislative actions to decrease…More

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Examining Prior Authorization in Health Insurance

This post explains what's known about how insurers use prior authorization as a tool to control costs and encourage cost-effective care, the state and federal laws that govern it, and ongoing policy debates over efforts to impose standards to limit or regulate its use.

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The Uncertain Future of Policies to Promote Access and Affordability Put in Place During the COVID-19 Pandemic

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.

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The Uncertain Future of Policies to Promote Access and Affordability Put in Place During the COVID-19 Pandemic

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.

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For ACA Enrollees, How Much Premiums Rise Next Year is Mostly up to Congress

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.

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For ACA Enrollees, How Much Premiums Rise Next Year is Mostly up to Congress

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.

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New Interactive Provides Essential Facts and Trends Related to Medicare Spending

A new KFF interactive provides essential facts and trends about spending on Medicare, the federal health insurance program that covers 65 million seniors and people with disabilities, or nearly 1 in 5 Americans. In 2020, Medicare spending accounted for 12 percent of the federal budget and 20 percent of national health care spending. Given its…More

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