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.
Much like a cell phone, an insurance plan is only as good as its network. Protections enacted at the federal and state levels are an important step toward strengthening private insurance provider networks. The Affordable Care Act created the first-ever provider network protections for private insurance consumers. These protections require health insurance marketplace plans to have adequate networks to meet their enrollees’ medical needs in a timely manner.
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.
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.
A recent, high-profile hospital acquisition in Massachusetts has sparked new debate about the continued trend toward consolidation among U.S. hospitals. Boston-based Partners HealthCare, already the largest health provider system in the state, made a bid earlier this year to acquire South Shore Hospital and its affiliated physician groups. An analysis of the proposed acquisition by the Massachusetts Health Policy Commission found that the merger could result in reduced market competition in the affected areas, leading to an increase in hospital charges of an estimated $23-26 million.
This new infographic and accompanying report offers a new perspective on the public debate around recipients of private, individual (non-group) insurance whose health plans are being terminated and who fear they may need to pay more for new coverage.
Shows how, under the Affordable Care Act, only 0.6 percent of Americans under age 65 will be at risk of losing their current individual market plan and will not be income-eligible for financial assistance with new insurance.
Learn about two types of health insurance models that insurers are implementing to encourage consumers to take a more active role in their health, and find out which model is more effective and why.
Learn how the Affordable Care Act protects consumers and how it specifically benefits different groups of people.
Job-Based Health Coverage and the Affordable Care Act: Why the Law Won't Cause Employers to Drop Coverage
This fact sheet refutes the myth that businesses will accept the financial penalty imposed by the Affordable Care Act rather than offer health insurance to their employees.