Private Health Insurance Market Reforms in the Patient Protection and Affordable Care Act (ACA).

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Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (15 download)

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Book Synopsis Private Health Insurance Market Reforms in the Patient Protection and Affordable Care Act (ACA). by : Annie L. Mach

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.

Private Health Insurance Market Reforms in the Patient Protection and Affordable Care Act (ACA)

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Author :
Publisher : Createspace Independent Pub
ISBN 13 : 9781478326908
Total Pages : 30 pages
Book Rating : 4.3/5 (269 download)

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Book Synopsis Private Health Insurance Market Reforms in the Patient Protection and Affordable Care Act (ACA) by : Annie L. Mach

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.

Private Health Insurance Market Reforms in the Patient Protection and Affordable Care Act

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Publisher :
ISBN 13 : 9781457831645
Total Pages : 28 pages
Book Rating : 4.8/5 (316 download)

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Book Synopsis Private Health Insurance Market Reforms in the Patient Protection and Affordable Care Act by : Annie L. Mach

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:

Private Health Insurance and the Affordable Care Act

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Publisher : Nova Science Publishers
ISBN 13 : 9781629487700
Total Pages : 0 pages
Book Rating : 4.4/5 (877 download)

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Book Synopsis Private Health Insurance and the Affordable Care Act by : Duke Riggs

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.

The Affordable Care Act

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Author :
Publisher : Greenhaven Publishing LLC
ISBN 13 : 0737776196
Total Pages : 130 pages
Book Rating : 4.7/5 (377 download)

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Book Synopsis The Affordable Care Act by : Tamara Thompson

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.

Health Insurance Exchanges Under the Patient Protection and Affordable Care Act (ACA)

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Author :
Publisher : Createspace Independent Pub
ISBN 13 : 9781480152809
Total Pages : 40 pages
Book Rating : 4.1/5 (528 download)

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Book Synopsis Health Insurance Exchanges Under the Patient Protection and Affordable Care Act (ACA) by : Bernadette Fernandez

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.

Patient Protection and Affordable Care Act

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Author :
Publisher : Nova Science Publishers
ISBN 13 : 9781619421936
Total Pages : 0 pages
Book Rating : 4.4/5 (219 download)

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Book Synopsis Patient Protection and Affordable Care Act by : Otis Cronin

Download or read book Patient Protection and Affordable Care Act written by Otis Cronin and published by Nova Science Publishers. This book was released on 2012 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: In March 2010, the 111th Congress passed health reform legislation, the Patient Protection and Affordable Care Act. Jointly referred to as the PPACA, the law increases access to health insurance coverage, expands federal private health insurance market requirements, and requires the creation of health insurance exchanges to provide individuals and small employers with access to insurance. This book provides an overview of major PPACA provisions, implementation and oversight activities, and current legal challenges.

Health Insurance Within the Affordable Care Act

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Author :
Publisher : Nova Science Pub Incorporated
ISBN 13 : 9781622577897
Total Pages : 136 pages
Book Rating : 4.5/5 (778 download)

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Book Synopsis Health Insurance Within the Affordable Care Act by : Campbell Richardson

Download or read book Health Insurance Within the Affordable Care Act written by Campbell Richardson and published by Nova Science Pub Incorporated. This book was released on 2012-12-17 with total page 136 pages. Available in PDF, EPUB and Kindle. Book excerpt: In March 2010, the 111th Congress passed health reform legislation, the Patient Protection and Affordable Care Act (ACA). ACA increases access to health insurance coverage, expands federal private health insurance market requirements, and requires the creation of health insurance exchanges to provide individuals and small employers with access to insurance. It also expands Medicaid coverage. The costs to the federal government of expanding health insurance and Medicaid coverage are projected to be offset by increased taxes and revenues and reduced spending on Medicare and other federal health programs. This book provides an overview of major ACA provisions, implementation and oversight activities.

Reforming Private Health Insurance

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Author :
Publisher : American Enterprise Institute
ISBN 13 : 9780844738628
Total Pages : 128 pages
Book Rating : 4.7/5 (386 download)

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Book Synopsis Reforming Private Health Insurance by : Mark A. Hall

Download or read book Reforming Private Health Insurance written by Mark A. Hall and published by American Enterprise Institute. This book was released on 1994 with total page 128 pages. Available in PDF, EPUB and Kindle. Book excerpt: Between 1987 and 1991, the portion of Americans covered by individually purchased health insurance dropped 40per cent. Assuming the US will continue to rely on private financing for health care, the author clarifies benefits to society from an efficient health insurance market.

Health Insurance Within the Affordable Care ACT

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Publisher :
ISBN 13 : 9781622577903
Total Pages : 138 pages
Book Rating : 4.5/5 (779 download)

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Book Synopsis Health Insurance Within the Affordable Care ACT by : Campbell Richardson

Download or read book Health Insurance Within the Affordable Care ACT written by Campbell Richardson and published by . This book was released on 2014-07-11 with total page 138 pages. Available in PDF, EPUB and Kindle. Book excerpt: In March 2010, the 111th Congress passed health reform legislation, the Patient Protection and Affordable Care Act (ACA). ACA increases access to health insurance coverage, expands federal private health insurance market requirements, and requires the creation of health insurance exchanges to provide individuals and small employers with access to insurance. This book provides an overview of major ACA provisions, implementation and oversight activities.

Health Insurance Premium Credits in the Patient Protection and Affordable Care Act (ACA)

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Author :
Publisher : CreateSpace
ISBN 13 : 9781478217763
Total Pages : 34 pages
Book Rating : 4.2/5 (177 download)

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Book Synopsis Health Insurance Premium Credits in the Patient Protection and Affordable Care Act (ACA) by : Bernadette Fernandez

Download or read book Health Insurance Premium Credits in the Patient Protection and Affordable Care Act (ACA) written by Bernadette Fernandez and published by CreateSpace. This book was released on 2012-07-09 with total page 34 pages. Available in PDF, EPUB and Kindle. Book excerpt: New federal tax credits were authorized in the Patient Protection and Affordable Care Act (ACA, P.L. 111-148, as amended), to help certain individuals pay for health insurance coverage, beginning in 2014. ACA requires “American Health Benefit Exchanges” to be established in every state by January 1, 2014, either by the state itself or by the Secretary of Health and Human Services (HHS). Exchanges will not be insurers, but will provide eligible individuals and small businesses with access to private health insurance plans. Generally, the plans offered through the exchanges will provide comprehensive coverage and meet all ACA market reforms, as applicable. One of the requirements that most exchange plans must meet is to provide a certain level of coverage generosity based on actuarial value. Each level of coverage generosity is designated according to a precious metal and corresponds to a specific actuarial value: Bronze (actuarial value of 60%), Silver (70%), Gold (80%), and Platinum (90%). To make exchange coverage more affordable, certain individuals will receive premium assistance in the form of federal tax credits. The premium credit will be an advanceable, refundable tax credit, meaning taxpayers need not wait until the end of the tax year in order to benefit from the credit, and may claim the full credit amount even if they have little or no federal income tax liability. Although the premium credits will not be available until 2014, the illustrations provided in this report are based on current federal poverty levels, to reflect how the estimated premium credit amounts compare to current income levels. Under ACA, the amount received in premium credits is based on income tax returns. These amounts are reconciled in the next year and can result in overpayment of premium credits if income increases, which must be repaid to the federal government. ACA limited the amount of required repayments. Since the enactment of ACA, these limits have been increased in order to raise revenues for other legislative initiatives (e.g., P.L. 111-309 and P.L. 112-9). Most recently, on June 7, 2012, the House passed H.R. 436, the Health Care Cost Reduction Act of 2012, which includes a measure that would remove all limits on repayment, making individuals fully liable for the full amount of any premium credit overpayment. Relative affordability of health insurance premiums individuals and families might face within health insurance exchanges will likely vary from exchange to exchange based on a host of factors, including enrollees' age, the varying prices paid by plans for medical goods and services, the breadth of the provider network, the provisions regarding how out-of-network care is paid for (or not), and the use of tools by the plan to reduce health care utilization (e.g., prior authorization for certain tests). Examples provided in the Appendix of this report depict a range by which premiums might reasonably be expected to vary based on enrollees' age, and variation in medical costs across geographic areas, for purposes of illustration only. Actual premiums will likely vary among health insurance exchanges based on a wide range of factors other than those depicted in this report.

Health-Care Utilization as a Proxy in Disability Determination

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Author :
Publisher : National Academies Press
ISBN 13 : 030946921X
Total Pages : 161 pages
Book Rating : 4.3/5 (94 download)

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Book Synopsis Health-Care Utilization as a Proxy in Disability Determination by : National Academies of Sciences, Engineering, and Medicine

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.

The Patient Protection and Affordable Care Act

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Author :
Publisher : Nova Science Publishers
ISBN 13 : 9781619421998
Total Pages : 161 pages
Book Rating : 4.4/5 (219 download)

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Book Synopsis The Patient Protection and Affordable Care Act by : Otis Cronin

Download or read book The Patient Protection and Affordable Care Act written by Otis Cronin and published by Nova Science Publishers. This book was released on 2012-04-01 with total page 161 pages. Available in PDF, EPUB and Kindle. Book excerpt: In March 2010, the 111th Congress passed health reform legislation, the Patient Protection and Affordable Care Act. Jointly referred to as the PPACA, the law increases access to health insurance coverage, expands federal private health insurance market requirements, and requires the creation of health insurance exchanges to provide individuals and small employers with access to insurance. This book provides an overview of major PPACA provisions, implementation and oversight activities, and current legal challenges.

Private Health Insurance

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Author :
Publisher :
ISBN 13 :
Total Pages : 66 pages
Book Rating : 4.:/5 (42 download)

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Book Synopsis Private Health Insurance by :

Download or read book Private Health Insurance written by and published by . This book was released on 1990 with total page 66 pages. Available in PDF, EPUB and Kindle. Book excerpt:

The Affordable Care Act and Health Insurance Markets

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Author :
Publisher : Rand Corporation
ISBN 13 : 0833081241
Total Pages : 117 pages
Book Rating : 4.8/5 (33 download)

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Book Synopsis The Affordable Care Act and Health Insurance Markets by : Christine Eibner

Download or read book The Affordable Care Act and Health Insurance Markets written by Christine Eibner and published by Rand Corporation. This book was released on 2013-08-29 with total page 117 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this report, the authors estimate the effects of the Affordable Care Act on health insurance enrollment and premiums for ten states (Florida, Kansas, Louisiana, Minnesota, New Mexico, North Dakota, Ohio, Pennsylvania, South Carolina, and Texas) and for the nation overall, with a focus on outcomes in the nongroup and small group markets.

Assessing Alternative Modifications to the Affordable Care Act

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Author :
Publisher : Rand Corporation
ISBN 13 : 0833091077
Total Pages : 70 pages
Book Rating : 4.8/5 (33 download)

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Book Synopsis Assessing Alternative Modifications to the Affordable Care Act by : Christine Eibner

Download or read book Assessing Alternative Modifications to the Affordable Care Act written by Christine Eibner and published by Rand Corporation. This book was released on 2014-10-21 with total page 70 pages. Available in PDF, EPUB and Kindle. Book excerpt: This report summarizes analysis in which the COMPARE microsimulation model was used to estimate how several potential changes to the Affordable Care Act, including eliminating the individual mandate and eliminating the law’s tax-credit subsidies, might affect 2015 individual market premiums and overall insurance coverage. The report also presents estimate how changes in young adult enrollment might affect 2015 individual market premiums.

The Affordable Care Act

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Publisher : Bloomsbury Publishing USA
ISBN 13 :
Total Pages : 160 pages
Book Rating : 4.2/5 (16 download)

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Book Synopsis The Affordable Care Act by : Purva H. Rawal

Download or read book The Affordable Care Act written by Purva H. Rawal and published by Bloomsbury Publishing USA. This book was released on 2016-01-18 with total page 160 pages. Available in PDF, EPUB and Kindle. Book excerpt: This is the first reference book to provide a detailed assessment of the Affordable Care Act, explaining the realities and myths surrounding one of the most divisive political struggles in recent U.S. history. The Affordable Care Act—also known as Obamacare—is one of the most controversial and politicized topics in the United States today. This timely book examines prominent claims about the legislation's drafting, debate, passage, and implementation, and discerns what is true and false about the law. Each of the text's eight chapters delves into the common beliefs, misinterpretations, and myths surrounding the act, tracing the history of the assertion and supporting or challenging its veracity through nonpartisan research and analyses. Chapters begin with an objective look at the claim's origins—with a brief focus on the person or group that conceived it and why—then set about clarifying or debunking it using evidence from research studies and reports from authoritative sources. Entries feature primary documents, a further reading section, and tables and graphs. Topics include the impact on health care costs for families, states, and the federal government; the effect of the Affordable Care Act on employer-sponsored insurance; and the role of health status on coverage under the Affordable Care Act.