The Urban Institute examines premiums and out-of-pocket costs, as well as total financial burdens for individuals with different characteristics enrolled in ACA-compliant nongroup coverage. Findings show that despite the financial assistance available, individuals across the income distribution who are ineligible for Medicaid can still face very high expenditures.
Even with federal government subsidies under the Affordable Care Act, a typical American buying coverage on public exchanges spends about one in 10 dollars they earn “on insurance premiums and out-of-pocket costs,”according to a new analysis.
Research from the Urban Institute shows typical single enrollees with incomes between $23,540 and $58,850 spend 10% of their incomes on premiums and out-of-pocket costs and the percentage rises if the enrollee has more medical needs.
A group of health policy analysts have collaborated on a set of proposals for replacing the Affordable Care Act (ACA) and also reforming other major portions of health care delivery, such as the tax treatment of employer-sponsored health insurance, Medicaid, Medicare, and Health Savings Accounts. Because so much attention has been paid to the repeal of the ACA by those who have opposed it, we believe it is important to focus on a serious proposal that could both replace this law and provide additional measures of reform, especially to the health care entitlement programs.
We believe our reform agenda represents such a proposal. Furthermore, none of us regards the pre-ACA health care system as an acceptable alternative.
If it’s December, it must be time for a massive, one-time, all-or-nothing annual spending bill. That’s just what has become of Congress’s core function over the past decade. This year’s version includes a 2,009 page omnibus appropriations bill and a 233 page tax bill mostly extending various “temporary” tax preferences and other provisions.
Republicans have majorities in both houses, so this bill reflects their priorities on the whole. But on health care, it’s actually most interesting for what it suggests about the Democrats—some meaningful number of whose votes are after all necessary for passage.
More than 2 million existing customers with insurance under the Affordable Care Act have had coverage renewed automatically for 2016 by HealthCare.gov, after they ignored government warnings to shop around to avoid surprise spikes in prices of health plans. According to data released Tuesday, 8.2 million people already have chosen — or have been automatically assigned to — health coverage next year through the federal insurance exchange.
A group of state insurance commissioners is developing a proposal to limit the amount that health insurers might have to pay out under the Affordable Care Act’s risk adjustment program, New Mexico Insurance Superintendent John Franchini told SNL.
The plan would install a so-called circuit breaker to prevent companies from paying more than 2% of their premium revenue into the program each year. That boundary would make insurers’ financial obligations more predictable and avoid the kinds of surprise payouts that contributed to the destabilization of several health plans in 2015.
Americans want to know what the next U.S. president will do to lower their rising health care costs, a priority shared by Republican and Democratic voters and second only to keeping the country safe. In all, 62% of people surveyed said they would want to know about a presidential candidate’s plan for reducing health care costs.
Using data from 49 states and Washington, D.C., the Commonwealth Fund analyzed changes in cost-sharing under health plans offered to individuals and families through state and federal exchanges from 2014 to 2015. They examined eight vehicles for cost-sharing, including deductibles, copayments, coinsurance, and out-of-pocket limits, and compared findings with cost-sharing under employer-based insurance.
For people without cost-sharing reductions, average copayments, deductibles, and out-of-pocket limits under catastrophic, bronze, and silver plans are considerably higher than under employer-based plans on average,
Despite advice to shop around before selecting a plan, consumers may find that getting answers about drug coverage can be an exercise in frustration, despite a federal health law requirement that insurers provide lists of the prescription medications included in their plans.
That’s because many treatments — particularly intravenous treatments like those used in cancer, hemophilia or multiple sclerosis — are covered under a separate part of an insurance plan, not the pharmacy benefit.
Two years ago, the Obama administration called the near-total, initial meltdown of the ObamaCare federal exchange a technical “glitch.” The term was widely ridiculed at the time, especially since it took weeks to fix the exchange’s website, healthcare.gov.
At Saturday night’s Democratic debate, front-runner Hillary Clinton called soaring health care costs and deductibles “glitches” resulting from the Affordable Care Act.