Download or read book Private Health Insurance Market Reforms in the Patient Protection and Affordable Care Act ACA written by Annie L. Mach and published by . This book was released on 2016 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This report provides background information about the private health insurance market, including market segments and regulation. It then describes each ACA market reform, grouped under the following categories: obtaining coverage, keeping coverage, cost of purchasing coverage, covered services, cost-sharing limits, consumer assistance and other health care protections, and plan requirements related to health care providers.
Download or read book Private Health Insurance Market Reforms in the Affordable Care Act ACA written by Annie L. Mach and published by . This book was released on 2014 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This report provides background information about the private health insurance market, including market segments and regulation. It then describes each Affordable Care Act (ACA) market reform.
Download or read book Private Health Insurance Market Reforms in the Patient Protection and Affordable Care Act ACA written by Annie L. Mach and published by Createspace Independent Pub. This book was released on 2012-07-28 with total page 30 pages. Available in PDF, EPUB and Kindle. Book excerpt: The private health insurance provisions in the Patient Protection and Affordable Care Act (P.L. 111-148, ACA, as amended) include market reforms that impose requirements on private health insurance plans. Such reforms relate to the offer, issuance, generosity, and pricing of health plans, among other requirements. ACA's market reforms largely focus on the individual and small group health insurance markets, and in this report the reforms have been grouped by effective dates: “immediate” market reforms that become effective prior to the full implementation date of ACA, and reforms that become effective on the full implementation date (January 1, 2014). ACA requires implementation of a number of reforms prior to its full implementation date (i.e., prior to plan years beginning on or after January 1, 2014). “Immediate” reforms include a process to review unreasonable rate increases; an Internet portal to assist consumers in identifying coverage options; prohibition on lifetime limits and restriction of annual limits; the prohibition on rescissions; coverage of preventive health services with no cost-sharing; extension of dependent coverage; prohibition of discrimination based on salary; standards related to medical loss ratios and rebates to plan participants; appeals process; coverage of preexisting health conditions for children; patient protections; uniform explanation of coverage documents; and reporting requirements regarding quality of care. Market reforms effective beginning in 2014 include nondiscrimination based on health status; guaranteed issue and guaranteed renewability; coverage of preexisting health conditions (regardless of age); nondiscrimination regarding clinical trial participation; rating restrictions; waiting period limitation; and nondiscrimination regarding health care providers. This report provides background information about the private health insurance market, including market segments and regulation. It describes each ACA market reform and notes any major implementation activity that has occurred (e.g., issuance of final rule from a department such as Health and Human Services). The appendices of the report provide additional information about the status of regulations relating to each reform and how the reforms apply to the different market segments and health plans.
Download or read book Private Health Insurance Market Reforms in the Affordable Care Act written by Mach and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Affordable Care Act written by Tamara Thompson and published by Greenhaven Publishing LLC. This book was released on 2014-12-02 with total page 130 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Patient Protection and Affordable Care Act (ACA) was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance coverage, and reduce the costs of healthcare overall. Along with sweeping change came sweeping criticisms and issues. This book explores the pros and cons of the Affordable Care Act, and explains who benefits from the ACA. Readers will learn how the economy is affected by the ACA, and the impact of the ACA rollout.
Download or read book Private Health Insurance Market Reforms in the Patient Protection and Affordable Care Act written by Annie L. Mach and published by . This book was released on 2012-11-05 with total page 28 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Private Health Insurance and the Affordable Care Act written by Duke Riggs and published by Nova Science Publishers. This book was released on 2014-03 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Private health insurance (PHI) is the predominate form of health insurance coverage in the United States. The Patient Protection and Affordable Care Act, as amended, expands federal private health insurance market requirements, and requires the creation of health insurance exchanges (marketplaces) to provide certain individuals and small employers access to private insurance, among other provisions. This book explains in further detail these private health insurance market reforms in the ACA and discusses the economic issues of the ACA.
Download or read book Health Care Utilization as a Proxy in Disability Determination written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-04-02 with total page 161 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.
Download or read book Enforcement of Private Health Insurance Market Reforms Under the Affordable Care Act ACA written by and published by . This book was released on 2014 with total page 8 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Impacts of the Affordable Care Act on Preparedness Resources and Programs written by Institute of Medicine and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Many of the elements of the Affordable Care Act (ACA) went into effect in 2014, and with the establishment of many new rules and regulations, there will continue to be significant changes to the United States health care system. It is not clear what impact these changes will have on medical and public health preparedness programs around the country. Although there has been tremendous progress since 2005 and Hurricane Katrina, there is still a long way to go to ensure the health security of the Country. There is a commonly held notion that preparedness is separate and distinct from everyday operations, and that it only affects emergency departments. But time and time again, catastrophic events challenge the entire health care system, from acute care and emergency medical services down to the public health and community clinic level, and the lack of preparedness of one part of the system places preventable stress on other components. The implementation of the ACA provides the opportunity to consider how to incorporate preparedness into all aspects of the health care system. The Impacts of the Affordable Care Act on Preparedness Resources and Programs is the summary of a workshop convened by the Institute of Medicine's Forum on Medical and Public Health Preparedness for Catastrophic Events in November 2013 to discuss how changes to the health system as a result of the ACA might impact medical and public health preparedness programs across the nation. This report discusses challenges and benefits of the Affordable Care Act to disaster preparedness and response efforts around the country and considers how changes to payment and reimbursement models will present opportunities and challenges to strengthen disaster preparedness and response capacities.
Download or read book Health Care Reform written by United States. Congress. House. Committee on Commerce. Subcommittee on Health and the Environment and published by . This book was released on 1996 with total page 184 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The US Health Insurance Market After the Affordable Care Act written by Pietro Tebaldi and published by . This book was released on 2016 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: The recent nation-wide health reform -- Patient Protection and Affordable Care Act, or simply ACA -- drastically altered the functioning of the health insurance industry in the US, opening many questions about how the system should be designed and regulated. While previous literature largely focused on health insurance provided through public programs or employer-sponsored insurance, in this dissertation I study the health coverage provision for outsiders: the twenty-one percent of the US population who as of 2013 were not offered insurance through their job, were not covered by the government, and yet did not purchase coverage in the so-called individual market. After the ACA, market institutions were largely redesigned with attention to this group, and policymakers are still dealing with great uncertainty about the efficacy of the new system and its costs for taxpayers in future years. In this context, my research advances our knowledge in two directions. On the one hand I provide empirical results of immediate policy relevance; on the other, I develop economic and statistical models to be used in this novel institutional environment. I consider three of the main channels through which, since 2014, the government affects the individual market for health insurance. First, state authorities determine how the geography of the state is divided in the local geographic markets in which insurers can participate and compete. Second, the ACA limits premium adjustments based on age or other observable characteristics of buyers. Third, the Federal government provides a large premium subsidy for all buyers whose income is between 133 and 400% of the Federal povery level. My dissertation contains three chapters, each of them analyzing the interaction of these three policies with the incentives of private health insurers.
Download or read book Health Insurance Market Reforms written by and published by . This book was released on 2012 with total page 4 pages. Available in PDF, EPUB and Kindle. Book excerpt: Guaranteed issue laws require insurance companies to issue a health plan to any applicant - an individual or a group - regardless of the applicant's health status or other factors. Currently, in most states, insurance companies can deny nongroup coverage to people based on their health status or their medical expenses over the past year. This means that an uninsured person who develops a certain condition, such as breast cancer, might not be able to buy health insurance. In such an instance, insurance companies can (and often do) refuse to issue a health insurance policy to that individual. The ACA requires significant changes to guaranteed issue laws. Beginning January 1, 2014, all individual and group health plans must guarantee issue policies to all applicants, regardless of health status or other factors. This fact sheet examines guaranteed issue laws in the individual and small group markets across the nation and how the transition to 2014 will change those markets.
Download or read book Navigating Health Care Reform written by and published by . This book was released on 2010 with total page 774 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Health Reform without Side Effects written by Mark V. Pauly and published by Hoover Press. This book was released on 2013-09-01 with total page 123 pages. Available in PDF, EPUB and Kindle. Book excerpt: Mark V. Pauly offers a detailed look at the individual insurance market in the United States. He explains how it works, suggests approaches to improvement that build on what currently works well, and provides a realistic assessment of how much improvement we can demand and expect. He concludes that, although there are some serious deficiencies in today's individual insurance market, there are also some important advantages in this market that should be preserved.
Download or read book Health Insurance Exchanges Under the Patient Protection and Affordable Care Act ACA written by Bernadette Fernandez and published by Createspace Independent Pub. This book was released on 2012-10-20 with total page 40 pages. Available in PDF, EPUB and Kindle. Book excerpt: The fundamental purpose of a health insurance exchange is to provide a structured marketplace for the sale and purchase of health insurance. The authority and responsibilities of an exchange may vary, depending on statutory or other requirements for its establishment and structure. The Patient Protection and Affordable Care Act (ACA, P.L. 111-148, as amended) requires health insurance exchanges to be established in every state by January 1, 2014. ACA provides certain requirements for the establishment of exchanges, while leaving other choices to be made by the states. Qualified individuals and small businesses will be able to purchase private health insurance through exchanges. Issuers selling health insurance plans through an exchange will have to follow certain rules, such as meeting the private market reform requirements in ACA. While the fundamental purpose of the exchanges will be to facilitate the offer and purchase of health insurance, nothing in the law prohibits qualified individuals, qualified employers, and insurance carriers from participating in the health insurance market outside of exchanges. Moreover, ACA explicitly states that enrollment in exchanges is voluntary and no individual may be compelled to enroll in exchange coverage. Exchanges may be established either by the state itself as a “state exchange” or by the Secretary of Health and Human Services (HHS) as a “federally facilitated exchange.” All exchanges are required to carry out many of the same functions and adhere to many of the same standards, although there are important differences between the types of exchanges. States will need to declare their intentions to establish their own exchanges by no later than November 16, 2012. ACA and regulations require exchanges to carry out a number of different functions. The primary functions relate to determining eligibility and enrolling individuals in appropriate plans, plan management, consumer assistance and accountability, and financial management. ACA gives various federal agencies, primarily HHS, responsibilities relating to the general operation of exchanges. Federal agencies are generally responsible for promulgating regulations, creating criteria and systems, and awarding grants to states to help them create and implement exchanges. A state that is approved to operate its own exchange has a number of operational decisions to make, including decisions related to organizational structure (governmental agency or a nonprofit entity); types of exchanges (separate individual and Small Business Health Options Program (SHOP) exchanges, or a merged exchange); collaboration (a state may independently operate an exchange or enter into contracts with other states); service area (a state may establish one or more subsidiary exchanges in the state if each exchange serves a geographically distinct area and meets certain size requirements); contracted services (an exchange may contract with certain entities to carry out one or more responsibilities of the exchange); and governance (governing board and standards of conduct). In general, health plans offered through exchanges will provide comprehensive coverage and meet all applicable private market reforms specified in ACA. Most exchange plans will provide coverage for “essential health benefits,” at minimum; be subject to certain limits on cost-sharing, including out-of-pocket costs; and meet one of four levels of plan generosity based on actuarial value. To make exchange coverage more affordable, certain individuals will receive premium assistance in the form of federal tax credits. Moreover, some recipients of premium credits may also receive subsidies toward cost-sharing expenses.
Download or read book The Affordable Care Act written by Tamara Thompson and published by Greenhaven Publishing LLC. This book was released on 2014-12-02 with total page 130 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Patient Protection and Affordable Care Act (ACA) was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance coverage, and reduce the costs of healthcare overall. Along with sweeping change came sweeping criticisms and issues. This book explores the pros and cons of the Affordable Care Act, and explains who benefits from the ACA. Readers will learn how the economy is affected by the ACA, and the impact of the ACA rollout.
