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.
This graphic compares how financial assistance for out-of-pocket health care costs changes when individuals move into Medicare from health insurance marketplace coverage or their state’s expanded Medicaid program.
The Affordable Care Act (ACA) improved insurance affordability and access for all Americans, including those eligible for Medicare, Medicaid, and private coverage offered through the health insurance marketplace. It strengthened Medicare in many ways — by closing the Part D prescription drug doughnut hole, offering free preventive services, and extending the life of the Medicare trust fund. However, the ACA’s improvements to Medicaid and private market insurance highlight longstanding shortfalls in programs that assist low-income Medicare beneficiaries with their health care costs.
Consumers, employers, and policymakers all need greater transparency in health care pricing. Learn what federal and state policymakers can do to improve access to health care price information.
Early last week, Health and Human Services Secretary Sylvia Burwell announced a new initiative designed to support state efforts to improve the health of Medicaid beneficiaries and the care they receive.
As part of the Medicaid Innovation Accelerator Program (IAP), the Center for Medicare Services (CMS) will develop new resources for and provide technical assistance to states engaged in efforts to reform their Medicaid programs. The IAP seeks to achieve the triple aim of better care, better health outcomes, and lower costs.
The evidence of Medicaid’s positive impact on hospitals is growing. A recent report from the Colorado Hospital Association found that hospitals in states that have expanded Medicaid are providing free care to fewer uninsured patients. Such care, also known as “charity care,” occurs when patients cannot pay their hospital bills, and represents a significant drain on hospital resources.
New Survey Finds That Most Consumers Oppose Penalties in Employee Health Insurance Wellness Programs
Earlier today, the Kaiser Family Foundation released findings from a new survey on consumer sentiment around the role of employee wellness programs. The poll found that, while 76 percent of the public supports employers offering wellness programs that promote healthy behaviors, the majority of consumers (75 percent) are opposed to employers charging higher premiums if workers don’t meet the health goals of their workplace wellness program.
Four Strategies for Improving Programs that Help Low-Income Medicare Beneficiaries with Health Care Costs
Low-income people with Medicare often struggle with high out-of-pocket health care costs. This brief identifies four strategies that advocates and policymakers can use to improve the programs that help these beneficiaries.
Our infographic shows how a consumer’s costs vary depending on the provider he or she chooses for a sample medical procedure that is subject to reference pricing.