Insurance Market Reform

This brief examines the three proposed federal regulations that detail how the ACA’s rules will operate in private insurance market reforms, essential health benefits and actuarial value, and wellness programs offered or required by employers under group health plans. 

This brief provides an overview of the federal guidelines around the EHB benchmark plans, which the states must submit by December 26, in addition to mapping out selections from the 26 states plus the District of Columbia that have already submitted their plans.

This brief analyzes the factors behind increased spending on private insurance, examining trends in premiums and cost-sharing in the group and non-group markets, how premium dollars are spent by insurers, which sectors are driving premiums upward, and the importance of price increases in explaining spending growth.

The ACA changes the small-group insurance market substantially beginning in 2014, but most changes do not apply to self-insured plans. This brief analyzes this exemption and the coverage decisions small-employers can make.

This proposed rule covers topics including the federal risk adjustment model, reinsurance parameters, cost-sharing reduction payment methodology, and user fees for insurers offering QHPs in federal exchanges.