Health insurance (1 - 10 of 138 items)
Medicaid: Key Policy and Data Considerations for Designing a Per Capita Cap on Federal Funding
GAO-16-726: Published: Aug 10, 2016. Publicly Released: Sep 9, 2016.
Through review of its prior reports, the literature and interviews with state Medicaid officials and subject matter experts, GAO identified several key interrelated policy considerations that could be useful should policymakers elect to pursue a per capita cap—a per-enrollee limit on federal Medicaid funding for states.Coverage and flexibility. Coverage entails decisions about whether all or a s...
Private Health Insurance: Premiums and Enrollment for New Nonprofit Health Insurance Issuers Varied Significantly in 2014
GAO-15-304: Published: Apr 30, 2015. Publicly Released: Jun 1, 2015.
As of January 2015, the Centers for Medicare & Medicaid Services (CMS)—the agency that administers and monitors the consumer operated and oriented plan (CO-OP) program—has disbursed about two thirds of the $2.4 billion in loans awarded to 23 CO-OPs. CMS has disbursed about $351 million in start-up loans and $1.2 billion in solvency loans. The percentage of start-up loan funding disbursed to CO...
Children's Health Insurance Program: Effects on Coverage and Access, and Considerations for Extending Funding
GAO-15-348: Published: Feb 27, 2015. Publicly Released: Mar 30, 2015.
Assessments of national data GAO reviewed identify positive effects of the State Children's Health Insurance Program (CHIP), and the quality measures reported by states help identify areas needing improvement.A mandated evaluation of CHIP published in 2014 noted that CHIP enrollees (1) had substantially better access to care, service use, and preventive care when compared with uninsured children;...
Private Health Insurance: Early Evidence Finds Premium Tax Credit Likely Contributed to Expanded Coverage, but Some Lack Access to Affordable Plans
GAO-15-312: Published: Mar 23, 2015. Publicly Released: Mar 23, 2015.
Early evidence suggests that the advance premium tax credit (APTC)—the refundable tax credit that can be paid on an advance basis—likely contributed to an expansion of health insurance coverage in 2014 because it significantly reduced the cost of exchange plans' premiums for those eligible. Although there are limitations to measuring the effects of the APTC using currently available data, surv...
Patient Protection and Affordable Care Act: Largest Issuers of Health Coverage Participated in Most Exchanges, and Number of Plans Available Varied
GAO-14-657: Published: Aug 29, 2014. Publicly Released: Sep 29, 2014.
Most of the largest issuers of health coverage from 2012 participated in the exchanges that the Patient Protection and Affordable Care Act (PPACA) required be established in all states in 2014. Previously, in 2012, while a large number of issuers participated in state individual and small-group markets, a small number of these participating issuers held a majority of the market share in terms of e...
Health Insurance Exchanges: Coverage of Non-excepted Abortion Services by Qualified Health Plans
GAO-14-742R: Published: Sep 15, 2014. Publicly Released: Sep 16, 2014.
Under the Patient Protection and Affordable Care Act (PPACA), insurance plans offered in health insurance exchanges—known as qualified health plans (QHP)—may cover abortion services as a benefit consistent with federal and state law. Federal law applicable to QHPs for the 2014 benefit year prohibits the use of federal funds made available to offset the cost of QHP coverage to pay for abortion...
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...
Federal Employees Health Benefits Program: Oversight of Carriers' Fraud and Abuse Programs
GAO-14-39: Published: Nov 14, 2013. Publicly Released: Dec 16, 2013.
The Office of Personnel Management (OPM) Healthcare & Insurance--Federal Employee Insurance Operations office, which we refer to as OPM's contracting office, monitors Federal Employees Health Benefits Program (FEHBP) carriers' compliance with requirements and other guidance for preventing, detecting, and eliminating fraud and abuse. These requirements include establishing a program to assess vulne...
CMS: Activities, Staffing, and Funding for the Center for Strategic Planning
GAO-13-377R: Published: Apr 1, 2013. Publicly Released: May 1, 2013.
CSP's activities, staff, and funding support strategic planning by individual CMS offices and centers as well as the agency itself. CMS officials told us that CSP assists individual offices and centers in developing strategic plans for their units, leads the agency's senior-level strategic planning meetings, and is helping to develop a centralized approach to monitor the implementation of CMS's ag...
Health Care Coverage: Job Lock and the Potential Impact of the Patient Protection and Affordable Care Act
GAO-12-166R: Published: Dec 15, 2011. Publicly Released: Dec 15, 2011.
Empirical research generally indicates that certain types of workers are more likely to remain in jobs they would otherwise leave in order to keep their employer-sponsored health care coverage, although research does not allow for a definitive answer on the prevalence or implications of this phenomenon for the overall labor market. The studies we reviewed generally found those workers who rely on...