Insurance premiums (1 - 10 of 116 items)
Private Health Insurance: In Most States and New Exchanges, Enrollees Continued to be Concentrated among Few Issuers in 2014 [Reissued on February 14, 2017]
GAO-16-724: Published: Sep 6, 2016. Publicly Released: Sep 6, 2016.
GAO found that enrollment in private health insurance plans remained concentrated among a small number of issuers in most states in 2014, including in the newly established exchanges. On average in each state and the District of Columbia, 11 or more issuers participated in each of three types of markets—individual, small group, and large group—from 2011 through 2014. However, in most states, t...
Patient Protection and Affordable Care Act: Concentration, Plan Availability and Premiums, and Enrollee Experiences in Health Insurance Markets Since 2014
GAO-17-383T: Published: Jan 31, 2017. Publicly Released: Jan 31, 2017.
GAO issued three reports in 2015 and 2016 on the early impact of the Patient Protection and Affordable Care Act (PPACA) on private health insurance markets.Market ConcentrationIn a 2016 report, GAO examined enrollment in private health-insurance plans in the years leading up to and through 2014, the first year of the exchanges established by PPACA, and found that in all years analyzed, markets wer...
Patient Protection and Affordable Care Act: Results of Enrollment Testing for the 2016 Special Enrollment Period
GAO-17-78: Published: Nov 17, 2016. Publicly Released: Dec 15, 2016.
The Patient Protection and Affordable Care Act (PPACA) requires that federal and state-based marketplaces verify application information—such as citizenship or immigration status—to determine eligibility for enrollment in a health plan, potentially including a subsidy. However, there is no specific legal requirement to verify the events that trigger a Special Enrollment Period (SEP), which is...
Patient Protection and Affordable Care Act: Most Enrollees Reported Satisfaction with Their Health Plans, Although Some Concerns Exist
GAO-16-761: Published: Sep 12, 2016. Publicly Released: Sep 12, 2016.
Available survey data show that most enrollees who obtained their coverage through the health insurance exchanges were satisfied overall with their qualified health plans (QHP) during the first few years that exchanges operated, according to five national surveys of QHP enrollees that GAO identified through its literature review. Specifically, most QHP enrollees who obtained their coverage through...
Small Employer Health Tax Credit: Limited Use Continues Due to Multiple Reasons
GAO-16-491T: Published: Mar 22, 2016. Publicly Released: Mar 22, 2016.
Claims of the small employer health tax credit have continued to be lower than thought eligible by government agency and small business group estimates, limiting the effect of the credit on expanding health insurance coverage through small employers. In 2014, about 181,000 employers claimed the credit, down somewhat from 2010 (see figure). These numbers are relatively low compared to the number of...
Private Health Insurance: Federal Oversight Premiums and Enrollment for Consumer Operated and Oriented Plans in 2015
GAO-16-326: Published: Mar 10, 2016. Publicly Released: Mar 17, 2016.
The Centers for Medicare & Medicaid Services' (CMS) monitoring of the consumer governed, nonprofit health insurance issuers—known as consumer operated and oriented plans (CO-OPs)—evolved as the CO-OP program matured, and as 12 of the 23 CO-OPs ceased operations on or before January 1, 2016. CMS's initial monitoring activities, starting when it began to award CO-OP program loans in early 2012,...
Private Health Insurance: The Range of Premiums and Plan Availability for Individuals in 2014 and 2015
GAO-15-687: Published: Aug 10, 2015. Publicly Released: Sep 9, 2015.
As of 2014, key provisions of the Patient Protection and Affordable Care Act (PPACA) resulted in the establishment of health insurance exchanges in each state and changed how insurers determined health insurance premiums. Individual market consumers generally had access to more health plans in 2015 compared to 2014, and in both years the lowest-cost plans were available through exchanges in most o...
Small Business Health Insurance Exchanges: Low Initial Enrollment Likely due to Multiple, Evolving Factors
GAO-15-58: Published: Nov 13, 2014. Publicly Released: Nov 13, 2014.
Though all of the Small Business Health Options Programs (SHOPs) required by the Patient Protection and Affordable Care Act were operational, many features were not yet available and enrollment was low as of June 2014. According to the Centers for Medicare & Medicaid Services (CMS), the agency that oversees the SHOPs, all 33 of the SHOPs run by CMS (federally facilitated, or FF-SHOPs) and 14 of th...
Private Health Insurance: The Range of Base Premiums in the Individual Market by County in January 2013
GAO-14-772R: Published: Sep 5, 2014. Publicly Released: Oct 6, 2014.
GAO is reporting the range of base premiums prior to underwriting for individual market health insurance plans as displayed on the HealthCare.gov Plan Finder in January 2013 for every county in each of the 50 states and the District of Columbia. The base premiums reflected information from data submitted by insurers to the...
Private Health Insurance: Early Effects of Medical Loss Ratio Requirements and Rebates on Insurers and Enrollees
GAO-14-580: Published: Jul 10, 2014. Publicly Released: Jul 10, 2014.
The Patient Protection and Affordable Care Act (PPACA) established federal minimum medical loss ratio (MLR) standards for the percentage of premiums private insurers must spend on their enrollees' medical care claims and activities to improve health care quality, as opposed to what they spend on administrative (“non-claims”) costs. Insurers report to the Centers for Medicare & Medicaid Service...