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Author: Congressional Service Publisher: Createspace Independent Publishing Platform ISBN: 9781722362843 Category : Languages : en Pages : 26
Book Description
The Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) requires health insurance exchanges to be established in every state. Exchanges are marketplaces in which consumers and small businesses can shop for and purchase private health insurance coverage. In general, states must have two types of exchanges: an individual exchange and a small business health options program (SHOP) exchange. Exchanges may be established either by the state itself as a state-based exchange (SBE) or by the Secretary of Health and Human Services (HHS) as a federally facilitated exchange (FFE). Some states have SBE-FPs: they have SBEs but use the federal information technology platform, including the federal exchange website www.Healthcare.gov. In states with FFEs, the exchange may be operated by the federal government alone or in conjunction with the state. States may have different structures for their individual and SHOP exchanges. Consumers who obtain coverage through the individual exchange may be eligible for financial assistance from the federal government. Financial assistance in the individual exchanges is available in two forms: premium tax credits and cost-sharing reductions. Small businesses that use the SHOP exchange may be eligible for small business health insurance tax credits. The tax credits assist small businesses with the cost of providing health insurance coverage to employees. The ACA generally requires that health insurance plans offered through an exchange are qualified health plans (QHPs). To be a certified as a QHP, a plan must be offered by a state-licensed issuer and must meet specified requirements, including covering the essential health benefits (EHB). QHPs sold in the individual and SHOP exchanges must comply with the same state and federal requirements that apply to QHPs and other health plans offered outside of the exchanges in the individual and small-group markets, respectively. Exchanges also may offer variations of QHPs, such as child-only or catastrophic plans, and non-QHP dental-only plans. This report provides an overview of the various components of the health insurance exchanges. It begins with summary information about how exchanges are structured and then discusses both individual and SHOP exchanges in terms of eligibility and enrollment, financial assistance for certain exchange consumers and small businesses, and enrollment assistance entities. The report also describes exchanges' role in certifying plans as qualified to be sold in their marketplaces and outlines the range of plans offered through exchanges. Finally, the report briefly addresses funding for the exchanges.
Author: Congressional Service Publisher: Createspace Independent Publishing Platform ISBN: 9781722362843 Category : Languages : en Pages : 26
Book Description
The Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) requires health insurance exchanges to be established in every state. Exchanges are marketplaces in which consumers and small businesses can shop for and purchase private health insurance coverage. In general, states must have two types of exchanges: an individual exchange and a small business health options program (SHOP) exchange. Exchanges may be established either by the state itself as a state-based exchange (SBE) or by the Secretary of Health and Human Services (HHS) as a federally facilitated exchange (FFE). Some states have SBE-FPs: they have SBEs but use the federal information technology platform, including the federal exchange website www.Healthcare.gov. In states with FFEs, the exchange may be operated by the federal government alone or in conjunction with the state. States may have different structures for their individual and SHOP exchanges. Consumers who obtain coverage through the individual exchange may be eligible for financial assistance from the federal government. Financial assistance in the individual exchanges is available in two forms: premium tax credits and cost-sharing reductions. Small businesses that use the SHOP exchange may be eligible for small business health insurance tax credits. The tax credits assist small businesses with the cost of providing health insurance coverage to employees. The ACA generally requires that health insurance plans offered through an exchange are qualified health plans (QHPs). To be a certified as a QHP, a plan must be offered by a state-licensed issuer and must meet specified requirements, including covering the essential health benefits (EHB). QHPs sold in the individual and SHOP exchanges must comply with the same state and federal requirements that apply to QHPs and other health plans offered outside of the exchanges in the individual and small-group markets, respectively. Exchanges also may offer variations of QHPs, such as child-only or catastrophic plans, and non-QHP dental-only plans. This report provides an overview of the various components of the health insurance exchanges. It begins with summary information about how exchanges are structured and then discusses both individual and SHOP exchanges in terms of eligibility and enrollment, financial assistance for certain exchange consumers and small businesses, and enrollment assistance entities. The report also describes exchanges' role in certifying plans as qualified to be sold in their marketplaces and outlines the range of plans offered through exchanges. Finally, the report briefly addresses funding for the exchanges.
Author: Tamara Thompson Publisher: Greenhaven Publishing LLC ISBN: 0737771496 Category : Young Adult Nonfiction Languages : en Pages : 130
Book Description
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: Namrata K. Uberoi Publisher: ISBN: Category : Languages : en Pages : 12
Book Description
The Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) requires health insurance exchanges to be established in every state. Exchanges are marketplaces where individuals and small businesses can shop for and purchase private health insurance coverage. States must have two types of exchanges: an individual exchange and a small business health options program (SHOP) exchange. Exchanges may be established either by the state itself as a state-based exchange (SBE) or by the Secretary of Health and Human Services (HHS) as a federally-facilitated exchange (FFE). In states with FFEs, the exchange may be operated solely by the federal government or in conjunction with the state. Persons who obtain coverage through the individual exchange may be eligible for financial assistance from the federal government. The financial assistance in the individual exchanges is available in two forms: premium tax credits and cost-sharing subsidies. Small businesses that use the SHOP exchange may be eligible for small business health insurance tax credits. The tax credits assist small businesses with the cost of providing health insurance coverage to employees. The ACA generally requires that health insurance plans offered through an exchange are Qualified Health Plans (QHPs). Typically in order to be a certified as a QHP, a plan must offer the essential health benefits, comply with cost-sharing limits, and meet certain market reforms. Exchanges may also offer other types of health insurance plans such as catastrophic and dental-only plans. This report provides an overview of the various components of the health insurance exchanges. The report includes summary information about how exchanges are structured, the intended consumers for health insurance exchange plans, and consumer assistance available in the exchanges, as specified in the ACA. The report also describes the availability of financial assistance for certain exchange consumers and small businesses and outlines the range of plans offered through exchanges. Moreover, the report provides a brief summary of the implementation and operation of exchanges since 2014.
Author: National Academies of Sciences, Engineering, and Medicine Publisher: National Academies Press ISBN: 030946921X Category : Medical Languages : en Pages : 161
Book Description
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.
Author: Fredrik C. Lewis Publisher: Nova Science Publishers ISBN: 9781628085754 Category : Health insurance Languages : en Pages : 0
Book Description
A central provision of The Patient Protection and Affordable Care Act (PPACA) requires the establishment of exchanges in each state, on-line marketplaces through which eligible individuals and small business employers can compare and select health insurance coverage from participating health plans. Exchanges are to begin enrolment by 1 October 2013, with coverage to commence 1 January 2014. States have some flexibility with respect to exchanges by choosing to establish and operate an exchange themselves (ie: state-based), or by ceding this authority to HHS (ie: federally facilitated). States may also choose to enter into a partnership with HHS whereby HHS establishes the exchange and the state assists with operating various functions. According to HHS, 18 states will establish a state-based exchange, while 25 will have a federally facilitated exchange. Seven states will partner with HHS. This book examines the states' responsibilities for establishing exchanges, the actions selected states have taken, and the challenges they have encountered.
Author: Fredrik C. Lewis Publisher: Novinka Books ISBN: 9781628085761 Category : Business & Economics Languages : en Pages : 105
Book Description
A central provision of The Patient Protection and Affordable Care Act (PPACA) requires the establishment of exchanges in each state, online marketplaces through which eligible individuals and small business employers can compare and select health insurance coverage from participating health plans. Exchanges are to begin enrollment by October 1, 2013, with coverage to commence January 1, 2014. States have some flexibility with respect to exchanges by choosing to establish and operate an exchange themselves (i.e., state-based), or by ceding this authority to HHS (i.e., federally facilitated). States may also choose to enter into a partnership with HHS whereby HHS establishes the exchange and the state assists with operating various functions. According to HHS, 18 states will establish a state-based exchange, while 25 will have a federally facilitated exchange. Seven states will partner with HHS. This book examines the states' responsibilities for establishing exchanges, the actions selected states have taken, and the challenges they have encountered.
Author: Wallace V. Bremer Publisher: Nova Science Publishers ISBN: 9781629486147 Category : Health insurance Languages : en Pages : 0
Book Description
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 requires health insurance exchanges to be established in every state by January 1, 2014. The 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 the ACA. While the fundamental purpose of the exchanges will be to facilitate the offer and purchase of health insurance, nothing in the ACA prohibits qualified individuals, qualified employers, and insurance carriers from participating in the health insurance market outside of exchanges. This book outlines the required minimum functions of exchanges, and explains how exchanges are expected to be established and administered under the ACA. The coverage offered through exchanges is discussed, and the book concludes with a discussion of how exchanges will interact with selected other ACA provisions.
Author: Christian Forrest Publisher: Nova Science Publishers ISBN: 9781634638982 Category : Health insurance Languages : en Pages : 0
Book Description
PPACA required by 1 January 2014, the establishment in each state of health insurance exchanges -- marketplaces where eligible individuals and small businesses can compare and select among insurance plans. Issuer participation, including the number of plans these issuers offer, is a key factor in the extent of consumer choice offered by the exchanges. The United States Government Accountability Office (GAO) was asked to examine the number and types of issuers participating in both the individual and small-business exchanges beginning in 2014, as well as how this compared with issuer participation in the individual and small-group markets prior to the exchanges. In this book, GAO describes the extent to which issuers that previously offered health plans in the individual and small-group markets participated in the exchanges in 2014; and the issuers that participated in 2014 exchanges and the health plans they offered. This book also describes Small Business Health Options Programs (SHOPs) functionality, enrollment, plan availability, and premiums; and stakeholders' views on key factors that have affected current SHOP enrollment or may affect future enrollment growth.
Author: Elliot Carpenter Publisher: Nova Snova ISBN: 9781536173741 Category : Languages : en Pages : 254
Book Description
Since 2014, millions of individuals have purchased coverage through the health insurance exchanges established under Patient Protection and Affordable Care Act (PPACA). PPACA altered the individual health insurance market by setting federal standards for coverage and subsidizing exchange coverage for certain low-income individuals. In the first 5 years of exchanges, issuers have moved in and out of the market and increased premiums, but little is known about issuers' claims costs or the factors driving their business decisions. Chapter 1 examines (1) claims costs of issuers participating in exchanges, and (2) factors driving selected issuers' changes in exchange participation, premiums, and plan design. GAO reviewed data from nine issuers participating in five states, which were selected to represent a range in size, tax status, and exchange participation. During open enrollment, eligible returning consumers may re-enroll in their existing health insurance exchange plan or choose a different plan. Those who do not actively enroll in a plan may be automatically re-enrolled into a plan. Chapter 2 examines 1) the extent to which plans identified as benchmark plans remained the same plans from year to year, and how premiums for benchmark plans changed; 2) the proportion of exchange consumers who were automatically re-enrolled into the same or similar plans, and how these proportions compared to those for consumers who actively re-enrolled, and 3) the extent to which consumers' financial responsibility for premiums changed for those who were automatically re-enrolled compared to those who actively re-enrolled. Chapter 3 discussed the amendments to title XIX of the Social Security Act to ensure health insurance coverage continuity for former foster youth. Certain individuals without access to subsidized health insurance coverage may be eligible for premium tax credits, as established under the Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended). The dollar amount of the premium credit varies from individual to individual, based on a formula specified in statute. Individuals who are eligible for the premium credit, however, generally are still required to contribute some amount toward the purchase of health insurance as described in chapter 4. During the summer of 2018, the Trump Administration issued final rules governing coverage offered through association health plans (AHPs) and short-term, limited-duration insurance. Chapter 5 describes how the Congressional Budget Office and the staff of the Joint Committee on Taxation (JCT) analyzed the new rules and determined how those rules would affect the agencies' projections of the number of people who obtain health insurance and the costs of federal subsidies for that coverage.
Author: Congressional Service
Author: Congressional Service
Author: Tamara Thompson
Author: Namrata K. Uberoi
Author: National Academies of Sciences, Engineering, and Medicine
Author: Fredrik C. Lewis
Author: Fredrik C. Lewis
Author: Wallace V. Bremer
Author: Christian Forrest
Author: 
Author: Elliot Carpenter