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Private Health Insurance Market Reforms In The Patient Protection And Affordable Care Act
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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.
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.
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:
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.
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.
Author :National Academies of Sciences, Engineering, and Medicine Publisher :National Academies Press ISBN 13 :030946921X Total Pages :161 pages Book Rating :4.3/5 (94 download)
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.
Book Synopsis Private Health Insurance Market Reforms in the Affordable Care Act (ACA). by : Annie L. Mach
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.
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.
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.
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.
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.
Book Synopsis Private Health Insurance Market Reforms in the Affordable Care Act by : Mach
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:
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.
Book Synopsis Enforcement of Private Health Insurance Market Reforms Under the Affordable Care Act (ACA). by :
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:
Book Synopsis The Future of Healthcare Reform in the United States by : Anup Malani
Download or read book The Future of Healthcare Reform in the United States written by Anup Malani and published by University of Chicago Press. This book was released on 2015-10-15 with total page 365 pages. Available in PDF, EPUB and Kindle. Book excerpt: In the years since the passage of the Patient Protection and Affordable Care Act (PPACA, or, colloquially, Obamacare), most of the discussion about it has been political. But as the politics fade and the law's many complex provisions take effect, a much more interesting question begins to emerge: How will the law affect the American health care regime in the coming years and decades? This book brings together fourteen leading scholars from the fields of law, economics, medicine, and public health to answer that question. Taking discipline-specific views, they offer their analyses and predictions for the future of health care reform. By turns thought-provoking, counterintuitive, and even contradictory, the essays together cover the landscape of positions on the PPACA's prospects. Some see efficiency growth and moderating prices; others fear a strangling bureaucracy and spiraling costs. The result is a deeply informed, richly substantive discussion that will trouble settled positions and lay the groundwork for analysis and assessment as the law's effects begin to become clear.
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.
Book Synopsis The US Health Insurance Market After the Affordable Care Act by : Pietro Tebaldi
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.
