When health plans design their provider networks, they need to ensure that these networks are adequate and provide meaningful access to care. The Affordable Care Act established the first-ever federal rights guaranteeing private insurance consumers access to adequate networks.
The Affordable Care Act did a lot to help uninsured consumers get health coverage, but it did not entirely resolve the very real problems with insurance affordability for low- and moderate-income consumers. These consumers often struggle to meet other living costs and, even once they have health insurance, may not be able to get the health care they need because they have trouble paying for costs associated with their premiums, office visits, and other types of health care.
What makes up an “adequate” network of health care providers for consumers from diverse racial and ethnic groups? Our new brief describes policies to help achieve such networks—and strategies to put these policies in place.
Open enrollment for the health insurance marketplace begins this November. As a result, health insurers are filing their proposed health insurance premium rates for 2015. To examine how rates may change for consumers buying policies in 2015, we reviewed filings and news reports from 12 states where proposed rates have received media attention. For each state, we looked at overall proposed premium rate changes, which are an average for each insurer. A consumer’s actual premium increase or decrease may be higher or lower than the average depending on age, location, and plan choice.
Designing Silver Health Plans with Affordable Out-of-Pocket Costs for Lower- and Moderate-Income Consumers
This brief identifies silver plan designs that make the upfront cost for care more affordable. You’ll also find policy and advocacy strategies to help advocates and policy makers effectively promote similar plan designs in other marketplaces across the country.
Explains the Qualified Individual (QI) program and provides a 50-state look at how people benefit, including how many people get help and how much money QI puts in their pockets.
This 50-state infographic series features state-specific data on how many people will be able to receive financial assistance for health insurance.
This 50-state infographic series features state-specific data on how many people with pre-existing health conditions will benefit from the Affordable Care Act.
Learn how many young adults are eligible for financial assistance to help buy health insurance in the marketplace, and how many young adults are uninsured.
Evaluating the Consumer Window-Shopping Experience in Health Insurance Marketplace Websites: A Comparative Analysis
Find out which elements make websites consumer-friendly when shopping for health insurance in the marketplace.