Health Insurance Cost Sharing

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How Insurance Marketplace Regulators Can Help Consumers Enroll in Better Coverage

The Affordable Care Act simplified shopping for health care by creating the individual health insurance marketplaces where plans are categorized into labeled tiers. Consumers rely on these labels when comparing plans. But the labels don't tell consumers everything they need to know.

Petra Rasmussen, David M. Anderson

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Addressing Surprise Medical Bills Without Raising the Cost of Health Care

Patients who try to stay within their insurers' networks can be hit with surprise bills when they unknowingly receive care from out-of-network physicians. How much should a physician be paid for providing a service that is critical but rendered without the patient's ready ability to choose an in-network provider?

Erin Lindsey Duffy, Mark W. Friedberg, et al.

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Medicare for All: Sounds Good, but What Does It Mean?

Traditional Medicare is popular and therefore can lend a good brand name to coverage expansion proposals, but its limits can be significant for some patients. Those proposing and evaluating “Medicare for All” proposals should consider whether and how these limits are addressed.

David Anderson, Jodi L. Liu @jodilliu, et al.

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Misconceptions About 'Medicare for All'

Medicare for All is a talking point for both major U.S. political parties. Would it be free? Would people have to switch doctors? Would waits be long? Misconceptions abound about single-payer proposals and their likely effects. Here are the facts.

Jodi L. Liu @jodilliu, Christine Eibner @Chrissyeibner

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Savings from a Single-Payer Health System Would Not Be Automatic

Polls have shown increasing public support for a single-payer system in the United States. Yet there is no agreement on how to set up and pay for a single-payer system or even how much it would cost.

Jodi L. Liu @jodilliu

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Four Steps That Could Stabilize the Health Insurance Market

Congress will soon discuss options to stabilize the individual market and ensure that all Americans have access to affordable coverage. Policymakers could encourage enrollment, make targeted investments to lower premiums, fund cost-sharing reductions, and enforce the individual mandate.

Christine Eibner @Chrissyeibner

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Insuring Younger Adults Through the ACA's Marketplaces: Options to Expand Enrollment

Whether or not the Affordable Care Act is repealed, having young adults participate in the individual health insurance market remains critical to achieving affordable premiums for everyone.

Evan Saltzman, Christine Eibner @Chrissyeibner

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Easing the Pain When Critical Medications Are No Longer Covered

Allowing insurance companies to limit the drugs they cover is necessary to give them leverage that can result in lower medication costs for all patients. Still, there are ways to make the process more transparent and manageable.

Erin Audrey Taylor

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Estimating the Impacts of the Trump and Clinton Health Plans

Donald Trump wants to repeal and replace the Affordable Care Act. Hillary Clinton wants to maintain and modify it. How could each proposal impact coverage, out-of-pocket costs, and the deficit?

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At 40, a Pioneering Health Care Experiment Remains Relevant

The impact of RAND's Health Insurance Experiment has been wide-reaching. The study's conclusions encouraged the restructuring of private insurance and helped increase the stature of managed care in the United States.

Michael D. Rich @michaeldrich

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Modifying the ACA's Family Subsidy Rules to Help Ensure Affordability

The ACA encourages workers to retain employer coverage by restricting their eligibility for marketplace subsidies. Modifying the policy could help 700,000 people gain coverage and lower spending for 1.6 million who are insured but face high health care costs under current ACA policy.

Amado Cordova, Sarah A. Nowak, et al.

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Bringing Sky-High Prescription Drug Prices Down to Earth

Increased competition among drug companies and improved bargaining power of insurers and consumers could help keep high prescription prices in check.

Erin Audrey Taylor

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What Happens If the ACA's Tax Credits Are Replaced with Premium Support?

As policymakers consider alternatives to reduce the federal government's financial burden from providing subsidies under the ACA, they should consider the consequences for enrollees. Existing premium-support models yield considerable savings for the federal government but could create age and income disparities in coverage.

Evan Saltzman, Christine Eibner @Chrissyeibner

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Policy Barriers to Best Practices: The Impact of Restrictive State Regulations on Access to Long-Acting Reversible Contraceptives

Long-acting reversible contraceptive (LARC) methods of birth control, which include the intrauterine device and subdermal implant, are highly effective, very safe, preferable to women, and cost effective. But some states' contraceptive policies create direct and indirect barriers to LARC use.

Priya Batra, Chloe E. Bird @ChloeBirdPhD

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Employer-Provided Health Insurance: Why Does It Persist, and Will It Continue after 2014?

As the ACA is implemented, policy makers should be attuned to potential inefficiencies and inequities created by a system with different regulatory and tax rules for small employers, large employers, and individual health plans. Attempts to equalize the playing field may be difficult.

Christine Eibner @Chrissyeibner