Affordable Care Act

Few Physicians Participate in Both Medicaid and Marketplace Plans

March 7, 2024 - Less than three in ten primary care physicians participating in Medicaid also participated in an average marketplace network, raising concerns about continuity of care for beneficiaries disenrolled from Medicaid. States resumed Medicaid eligibility determinations in April 2023 before the COVID-19 public health emergency ended. As of March 2024,...


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ACA Marketplace Enrollment Up By 33%, Surpassing 19M Enrollees

by Victoria Bailey

More than 19 million people have enrolled in Affordable Care Act (ACA) marketplace plans for 2024 coverage, HHS announced. This figure reflects enrollment data as of December 15, 2023, for states...

What Health Plans Are Available For People With Disabilities?

by Victoria Bailey

Public and private payers alike offer a multitude of benefits for people living with disabilities. According to the CDC, up to 27 percent of adults in the United States have some type of disability, including mobility, cognition,...

How Do Payers Cover Prenatal, Postpartum Care for Pregnant People?

by Victoria Bailey

Prenatal, perinatal, and postpartum care help ensure healthier pregnancies and better birth outcomes for pregnant people. Access to this essential care comes easier with adequate health insurance. Pregnant people are almost guaranteed...

An Overview of 2024 Coverage for Veterans Beyond Veterans Affairs

by Kelsey Waddill

Although US veterans have many coverage options, including Veterans Affairs (VA), Medicaid, and the Affordable Care Act (ACA) marketplace, many are projected to remain uninsured in 2024, according to a...

How Public, Private Payers Cover Care for the LGBTQ+ Population

by Victoria Bailey

In a country with rampant health disparities, health insurance coverage can be the difference between accessing necessary services and going without care. How health plans cover care for socially disadvantaged and vulnerable populations...

9 Trends To Watch During ACA Marketplace 2024 Open Enrollment

by Kelsey Waddill

Going into the 2024 open enrollment season, healthcare stakeholders should be prepared for nine key trends in Affordable Care Act marketplace enrollment, according to experts from KFF. First,...

Price May Drive Affordable Care Act Marketplace Plan Selection

by Kelsey Waddill

The Affordable Care Act (ACA) marketplace was designed to incentivize enrollees to choose specific plans based on price and it seems to be fulfilling that goal, an analysis from the Urban Institute...

Top 5 Largest Health Insurance Payers in the United States

by Editorial Staff

The Affordable Care Act (ACA) and Medicare Advantage plans continue to bolster enrollment for major payers. Enhanced premium subsidies on the ACA market along with greater federal investments in...

ACA Marketplace Premiums Set to Rise Again, Inflation a Key Factor

by Sarai Rodriguez

Even as inflation seems to be plunging from its peak, the ongoing pressure from high medical costs is set to push ACA Marketplace premiums up to an average of 6 percent in 2024, according to...

HHS Attributes Record Low Uninsurance Rate to ACA Enrollment

by Mark Melchionna

Following the Affordable Care Act (ACA) open enrollment period that concluded in January 2023, the United States Department of Health and Human Services (HHS) reported that uninsurance among American...

English Proficiency Can Impact Care Disparities, Coverage Rates

by Kelsey Waddill

Limited English proficiency (LEP) can significantly stunt a patient’s ability to communicate with doctors and receive care, which results in broader care disparities along racial and ethnic...

ARPA Reduced Fiscal Challenges on CA Affordable Care Act Marketplace

by Kelsey Waddill

Enrollees in California’s Affordable Care Act marketplace were less likely to experience financial barriers in 2021 compared to 2017 due to provisions in the American Rescue Plan Act (ARPA) that...

HHS Proposed Rule Aims to Distinguish STLDI from Comprehensive Plans

by Kelsey Waddill

The Department of Health and Human Services (HHS), the Department of Labor, and the Department of the Treasury have released a notice of proposed rulemaking that applies to short-term, limited-duration...

Medicare Advantage Plan Payment Cuts Did Not Impact Enrollment Growth

by Victoria Bailey

Medicare Advantage plan payment cuts under the Affordable Care Act (ACA) did not lead to enrollment reductions, suggesting that further payment reform could minimize spending without hurting access to...

Health Plans Must Continue Covering Preventive Care Services

by Victoria Bailey

A federal appeals court approved an agreement between parties in Braidwood Management v Becerra, preserving the mandate requiring health plans to cover preventive care services based on recommendations...

Loss of ACA Preventive Care Mandate Could Impact 10M Enrollees

by Kelsey Waddill

With the Affordable Care Act’s preventive care coverage requirement under scrutiny, Peterson-KFF researchers investigated how many Americans rely on the law’s coverage and determined that...

What Employers Need to Know About ERISA Compliance for Health Plans

by Kelsey Waddill

The Employee Retirement Income Security Act of 1974 (ERISA) dominates the health insurance industry and regulates coverage for around 139 million Americans in 2.5 million health plans, making familiarity with ERISA compliance critical for...

4 Categories of Preventive Care Services Covered Under the ACA

by Kelsey Waddill

There are four types of services that private payers and employers are required to cover under the Affordable Care Act (ACA) preventive care services provision, which include screenings and...

Court Upholds ACA Preventive Care Compliance Amid Legal Proceedings

by Kelsey Waddill

The US Court of Appeals for the Fifth Circuit determined that employers and health insurers must maintain compliance with Affordable Care Act (ACA) preventive care services provision while the law...