Affordable Care Act

Employer-Sponsored Health Costs Rise, Call For ACA Expansion

by Hannah Nelson

With rising employer-sponsored health plan costs, limited options under the Affordable Care Act (ACA), and millions of people losing employer-sponsored health coverage since the onset of COVID-19,...

3 Solutions for High-Cost Payer-Coverage for Low-Income People

by Kelsey Waddill

Healthcare coverage remains out of reach for many low-income Americans due to cost, but three innovative solutions for Connecticut might shed light on how to bolster payer coverage affordability, a...

ACA Marketplaces Gain Payers in 2021, Rural Areas Still Struggle

by Kelsey Waddill

Over three-quarters of Affordable Care Act marketplace enrollees will have three or more payer options in 2021, a Kaiser Family Foundation (KFF) report found. That represents an 11 percent increase...

Market Concentration Escalated in Small Group, Individual Markets

by Kelsey Waddill

The Government Accountability Office (GAO) has released a report finding high market concentration across the payer industry and that having increased health plan options does not necessarily reduce...

Individual Insurance Market Premiums Cover Widely-Used Services

by Kelsey Waddill

The individual health insurance market’s premiums mostly go towards highly utilized services, a Robert Wood Johnson study discovered. “The requirement that these essential benefits be...

Legal, Payer Experts Unpack SCOTUS Affordable Care Act Hearing

by Kelsey Waddill

As the Supreme Court deliberates the fate of the Affordable Care Act after hearing the oral arguments, payers and the public alike are processing the court case and its implications for the healthcare...

Unemployed Turn to Affordable Care Act Health Plans for Coverage

by Kelsey Waddill

After losing their employer-sponsored health plans, many adults are shifting to public and non-group plans, emphasizing the important role that the Affordable Care Act plays in health insurance, an...

Supreme Court Hears Case on Affordable Care Act Constitutionality

by Kelsey Waddill

At 10am EST on November 10, the Supreme Court heard the oral arguments in the California v Texas regarding the Affordable Care Act’s constitutionality. The case is pivotal as the outcomes could...

Louisiana’s Population of Uninsured Children Jumped 28.2% in 2019

by Kelsey Waddill

The number of uninsured children in Louisiana in 2019 was 28.2 percent higher than its low number of uninsured children in 2017, following a national trend in childhood uninsurance, the Louisiana...

Pros, Cons of Individual Coverage Health Reimbursement Arrangements

by Kelsey Waddill

Individual coverage health reimbursement arrangements (ICHRAs), which have been offered as the alternative to the Affordable Care Act, have negative impacts on low-income New Yorkers, according to a...

How Do Medicaid Programs Cover Pediatric Curative, Hospice Care?

by Kelsey Waddill

States use Affordable Care Act flexibilities in innovative ways to set definitions for curative care, implement reimbursement models, and care coordination in Medicaid pediatric care for children with...

Average ACA Exchange Premiums Drop for Third Year Running

by Kelsey Waddill

The downward trend in ACA exchange premiums continued this year with the average premium for the benchmark plan dropping two percent for 2021 coverage year, although some premiums remain up to 36...

Medicare Advantage Gross Margins Rise 41% Over 2019 Margins

by Kelsey Waddill

Compared to 2019, the fully-insured group health insurance markets and Medicare Advantage markets have seen their margins increase and loss ratios decrease in the first half of 2020, with Medicare...

What Happens if SCOTUS Overturns ACA, Besides Coverage Loss?

by Kelsey Waddill

Update 11/5/2020: This article has been corrected to state that the Supreme Court will hear the oral arguments regarding the Affordable Care Act’s constitutionality on November 10, 2020. A...

How to Improve Children’s Health Insurance Coverage Nationally

by Kelsey Waddill

Children’s health insurance coverage is not stable even under the Children’s Health Insurance Program (CHIP), a recent study published in Health Affairs discovered. “The current...

Medicaid Expansion Could Mean $5.4B in Federal Funds for TX

by Kelsey Waddill

Under Medicaid expansion, Texas could receive around $5.4 billion from the federal government to cover Medicaid costs. The state could also cover a larger portion of its significant uninsured...

How an Overturned Affordable Care Act Would Impact Payer Industry

by Kelsey Waddill

Since the passing of late Supreme Court Justice Ruth Bader Ginsburg, many have questioned whether the Affordable Care Act is at risk of being overturned, a potentiality that would be extremely...

Overview of Federal Policy Around Pre-Existing Conditions Coverage

by Kelsey Waddill

Update 11/5/2020: This article has been corrected to state that the Supreme Court will hear the oral arguments regarding the Affordable Care Act’s constitutionality on November 10, 2020. A...

COVID-19 Has Negative Impact on Stalling ACA Marketplaces

by Kelsey Waddill

Healthcare improvements through the Affordable Care Act marketplaces had stalled before the coronavirus pandemic struck the US and COVID-19 has only further exposed the system’s weaknesses, the...

Payers Begin To Pay Individual, Small Group Rebates Amid COVID-19

by Kelsey Waddill

Major payers are beginning to send out individual and small group rebate checks for 2019, providing some financial relief for members, as the Tennessee Department of Commerce and Insurance...